Health Tip: Build Strong Bones

(HealthDay News) -- Osteoporosis is a condition in which bones become weak, brittle and may break easily.

The National Women's Health Information Center offers these suggestions to help prevent osteoporosis:

• Get plenty of calcium by eating or drinking dairy products, or by taking calcium supplements.
• Get enough vitamin D, through exposure to sunlight (use sunscreen), supplements or milk products.
• Eat a diet rich in vitamins and protein.
• Get enough weight-bearing exercise (where your body works against gravity). Examples include lifting weights or climbing stairs.
• Avoid smoking and excessive alcohol use.
• Take medication to specifically treat or help prevent bone loss.

Build Better Bones and Prevent Osteoporosis

How people in their 30s, 40s, and 50s can fend off osteoporosis
by Ross Weale

Strong bones are important for healthy aging. To avoid osteoporosis and up your bone density, eat leafy greens, quit smoking, and drink your milk! Watch Health magazine contributor Samantha Heller's appearance on the Today show on March 26 to learn more.



SAMANTHA HELLER
Samantha Heller, RD, is the nutrition coordinator at the Fairfield Connecticut YMCA. A certified dietitian/nutritionist and exercise physiologist, Heller earned her master's degree in nutrition and applied physiology from Teachers College at Columbia University. She served as the senior clinical nutritionist and exercise physiologist at NYU Medical center in New York City for almost a decade and created and ran the outpatient nutrition program for the NYU Cardiac Rehabilitation Program. She has also been a fitness instructor for 15 years. Heller specializes in nutrition, wellness, stress management, and fitness for people who are fighting heart disease, diabetes, cancer, and obesity.

A contributing editor to Health magazine, her writing has also appeared in numerous other magazines, including Men's Fitness, Men's Health, and Glamour, as well as sites such as Fitness.com.

Depression Linked to Bone Loss in Younger Women

(HealthDay News) -- Premenopausal women struggling with depression have lower bone mass than do non-depressed women in the same age range, a new study found.

The bone loss was most pronounced in certain regions of the hip, which is troubling given that hip fractures are one of the most serious -- and potentially fatal -- consequences of osteoporosis.

The level of bone loss seen in the depressed women was the same or higher than that associated with other, established risk factors for osteoporosis, including smoking, low calcium intake and lack of physical exercise, the researchers said.

The findings, published in the Nov. 26 issue of the Archives of Internal Medicine, could have implications for the prevention of osteoporosis.

"Premenopausal women with depression should be screened for low bone mass," said Dr. Giovanni Cizza, senior author of the study who conducted the research while at the U.S. National Institute of Mental Health. "They should do a bone mineral density measurement, because osteoporosis is a silent condition. Until someone fractures, you don't know you have osteoporosis."

Cizza is now a staff clinician at the U.S. National Institute of Diabetes and Digestive and Kidney Diseases.

A woman's bone mass peaks during youth then thins after menopause. Previous, preliminary studies had suggested that depression might be a risk factor for low bone mass in older women.

For this study, Cizza and his colleagues looked at 89 women with depression and 44 women without depression. The women ranged in age from 21 to 45. The depressed women were taking antidepressant medications.

Seventeen percent of the depressed women had thinner bone density in the femoral neck, a vulnerable part of the hip. Only 2 percent of non-depressed women, by contrast, had thinner bone in this area.

Twenty percent of depressed women also had low bone density in the lumbar spine, compared with 9 percent of the non-depressed women.

Blood and urine samples also revealed that the depressed women had lower levels of "good" proteins called cytokines. "The bad cytokines that may cause bone loss are higher," Cizza said.

It's not clear what role antidepressants might play, but by relieving the depression, the drugs may also help bone mineral density, the researchers said.

More information
To learn more about bone health, visit the National Osteoporosis Foundation.

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Quitting Hormone Replacement Therapy?

Provided by: DrWeil.com

Q: I'm currently on hormone replacement therapy (HRT) and have been for 10 years. I would like to get off. How do I do this? Do I just quit, or do I need to back it down? -- Terri M.

A: Conventional medical wisdom holds that since you've been on HRT for so long, it would be best to wean yourself off slowly. However, the few studies on this subject suggest that it really doesn't matter whether you go cold turkey or withdraw from the hormones gradually: there seems to be no difference in the incidence of menopausal symptoms that develop as a result.

One study, published in the December 2003 issue of Obstetrics and Gynecology, found that about one-quarter of the women participating were unable to discontinue hormone therapy because of the withdrawal symptoms they experienced.

The women who had the most trouble quitting had begun taking estrogen after a hysterectomy, and had been on it for 10 years or more. Of the women in the study who succeeded in withdrawing from HRT, 71 percent quit abruptly and 29 percent tapered off HRT.

There was no difference in the incidence of menopausal symptoms between the two groups. Another study, published in the May, 2004 issue of the Journal of Women's Health, also found no difference in symptoms between women who quit abruptly and those who tapered off. If you decide to wean yourself off HRT, discuss your plan with your doctor. I suggest cutting back on HRT over the course of two months.

You can do this by taking decreasingly lower doses of estrogens. You're probably taking 0.625 mg of estrogen daily. You want to bring this down to 0.4, then 0.3 mgs daily. Either ask your physician to prescribe lower-dose estrogen or start taking your pills every other day, instead of daily. Continue taking your full dose of progestin whenever you take estrogen. If your HRT prescription is for a pill that combines both hormones, ask your physician for separate prescriptions so that you can slowly lower your estrogen dose.

Once you're off the hormones, you may experience hot flashes, night sweats or mood swings, and within two or three months you're likely to notice vaginal dryness and loss of fullness of your breasts. Hormonal changes can also lead to some temporary hair loss. If vaginal dryness becomes problematical, try Replens, a non-hormonal gel, which should be applied three times a week, or use the lubricant Astroglide at the time of intercourse. Both are available over-the-counter. Alternatively, speak to your physician about prescription estrogen creams that can be applied vaginally or the vaginal ring (Estring) that time-releases estradiol (a natural form of estrogen) daily; the ring has to be replaced every 90 days.

If you were taking HRT to protect against osteoporosis, make sure that you're getting 1,500 mg of calcium daily from your diet and, if necessary, from supplements. Weight-bearing exercise, such as brisk walking, along with strength training can protect your bones. If a bone density test shows that you're at high risk of osteoporosis, you may want to consider taking Fosamax (alendronate sodium), Actonel (risedronate sodium) or Evista (raloxifene), prescription medications that can help strengthen bone.

Many women find relief from hot flashes, night sweats and vaginal dryness by taking black cohosh (Cimifiuga racemosa) plus 800 IUs of vitamin E daily. Alternatives include the supplements dong quai and evening primrose oil, which work for some women. Two to three daily servings of whole soy foods (tofu, tempeh, edamame, and soy milk) will give you some safe plant estrogen (phytoestrogens) that may help relieve symptoms. If these natural approaches don't help, talk to your physician about Effexor (venlafaxine) or other drugs that can relieve hot flashes.
Andrew Weil, MD

Cystic Fibrosis and Nutrition

Cystic Fibrosis and Nutrition
June 2, 2006 02:55:02 AM PST

Cystic fibrosis (CF), called "65 Roses" by many of the 30,000 children and adults in the United States with the inherited genetic disease, particularly affects the respiratory and digestive systems.

CF makes children sick by disrupting the normal function of epithelial cells - cells that make up the sweat glands in the skin and that also line passageways inside the lungs, liver, pancreas, and digestive and reproductive systems.

A defect in these cells causes problems with the balance of salt and water in the body, leading it to produce thick mucus, which clogs the lungs, setting the stage for infections and other breathing problems. In children with CF, this mucus can also prevent the normal absorption of key nutrients and fat in the intestines, leading to poor digestion, slow growth, difficulty gaining weight, greasy bowel movements, and a decreased ability to fight infection.

About 85% to 90% of CF patients have pancreatic insufficiency by the time they're 8 or 9 years old. This means that the enzymes created in the pancreas that digest fat, starch, and protein aren't properly passed into the intestines. This causes problems in absorbing the necessary amounts of several important nutrients.

Important ways that you can help your child with CF grow healthy and strong include providing good overall nutrition along with extra fat and calories and prescribed enzymes (see the section Beyond Food - Enzymes and Tube Feeding).

Your Child's Nutritional NeedsIn general, children with CF may need 30% to 50% more of the recommended daily allowance of calories for their age group. This means that:
A toddler with CF may need 1,700 to 1,950 calories daily.
A child with CF may need 2,300 to 3,000 calories daily.
A teen with CF may need 2,900 to 4,500 calories daily.
These calorie needs may be even higher when a child is ill (even a low-grade infection can greatly increase your child's calorie needs).

Every child with CF has different nutritional needs. You'll work with your child's CF dietitian to determine how many calories he or she needs each day. The dietitian will track your child's growth and weight gain over time and will provide you with a nutrition plan.

Some parents of children with CF (and the kids as well) find that counting calories is bothersome. For this reason, it may be more helpful to focus more generally on your child's growth pattern and on adding calorie boosters with fat in them to the foods your child normally eats. That's because gram for gram, fat has more than twice the number of calories as protein and carbohydrates.

In addition to calories, kids with CF have some specific nutritional needs to help them thrive:
Calcium. Patients with pancreatic insufficiency have difficulty absorbing calcium and are especially at risk for developing osteoporosis (weak, brittle bones).

Even patients who don't have pancreatic insufficiency have a greater risk of developing the condition. All dairy products are good sources of calcium (and the full-fat varieties are good sources of fat and calories as well). Many juices also now include calcium.

Essential fatty acids. The body needs to get these particular types of fat from the diet. Found in plant oils, safflower oil, and soybean oils, they help in the building of cell membranes and may play a role in lung function.

Fat-soluble vitamins (vitamins A, D, E, and K). Important for growth and healing, these vitamins are absorbed along with fat. And because most children with CF have trouble digesting fat, they often have low levels of fat-soluble vitamins and need to take supplements.

Iron. Many children (both with and without CF) are at risk for developing iron deficiency anemia, which can cause fatigue and poor resistance to infection. Fortified cereal, meats, dried fruits, and deep green vegetables are good sources of iron.

Salt. Children with CF lose a lot of salt in their sweat, especially during hot weather and when they exercise. Your CF dietitian may ask you to add salt to your infant's formula and to give your older child salty snacks. During hot weather and when your child plays sports, the dietitian may recommend sending sports drinks to school for activities and physical education class.

Zinc. Important for growth, healing, and fighting infection, zinc is found in meats, liver, eggs, and seafood.

Meals at Home and Away. You'll need to work with your child's CF dietitian to create meal plans that include plenty of snacks, especially for toddlers who eat smaller meals. (Toddlers with or without CF may eat as many as six small meals a day.) When your child is older, schedule snacks so that he or she is eating enough, but isn't simply snacking all day.

Yahoo! Health: Children's Health News


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Yoga Offers Mental, Physical Relief for the Chronically Ill

Patients dealing with illnesses ranging from AIDS and cancer to osteoporosis and Crohn's disease are turning to condition-specific yoga classes, according to a report in the New York Times, my favorite newspaper in the world. Unlike larger health club classes, however, only certain poses are incorporated, and at the appropriate pace and level.

I'm happy medical experts are increasingly recognizing the benefits of alternative medicine in treating and preventing a range of illnesses. I agree the health benefits of stretching can be particularly valuable.

More and more, doctors recommend the classes for the stress-relieving benefits. However, patients are reporting the sessions make them more comfortable and even help alleviate the symptoms and side effects of medication. Additionally, the support of exercising with others dealing with the same condition can have important mental health benefits too.

Recent studies indicate, among other things, yoga can lower fatigue in people with multiple sclerosis and reduce anxiety in cancer, heart disease and hypertension patients. Experts agree, yoga does not treat or cure the disease, but it does make the symptoms more tolerable and lessens the anxiety illness creates.
New York Times December 15, 2005 Registration Required
Kaiser Network December 15, 2005

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Vitamin Supplement Could Help Treatment-resistant Asthma

Science Daily Dec 9 2005 11:31PM GMT


Asthma is usually treated very effectively with inhaled steroids but for some patients, taking steroid tablets is the only way of controlling their condition, and this can cause considerable side effects. Unfortunately a sub-group of people with severe asthma fail to show clinical improvement, even with high doses of oral steroids, limiting their treatment options.

Professor Tak Lee, Director of the MRC-Asthma UK Centre in Allergic Mechanisms of Asthma at King's College London and Imperial College, who was involved in the latest study, explained its importance: 'This research is really exciting and points the direction towards potential new strategies for reversing steroid resistance. This has major implications for how to treat patients with severe asthma and could also substantially reduce the use of NHS resources.'

The team's results imply that steroid treatment works, at least in part, by inducing the T-cells of the immune system to synthesise a secreted signalling molecule, called IL-10. This molecule can inhibit the immune responses that cause the symptoms of allergic and asthmatic disease.
Unlike T-cells from healthy individuals, or patients that respond to steroids, T-cells taken from patients who are steroid resistant do not produce IL-10 when cultured in vitro with the steroid, dexamethasone.

However, the researchers found that when vitamin D3 was added to the culture medium along with dexamethasone, this defect was reversed and the previously steroid-resistant cells were able to respond to the treatment by producing IL-10 to the same extent as T-cells taken from steroid-responsive patients.

Adding vitamin D3 to cultures of T-cells from healthy individuals or from steroid-responsive patients made these cells even more responsive to steroids than before.

Dr Catherine Hawrylowicz, who led the King's research team said: 'The hope is that this work will lead to new ways to treat people who don't respond to steroid treatment as it currently stands, and it could also help those people who are on heavy doses of steroids to reduce the amount of medication they are taking.'

To test whether this therapy could work in practice the team at King's went on to perform a pilot experiment where people with asthma who were unresponsive to steroids took daily vitamin D3 supplements for seven days. The researchers took blood samples to assess whether the patients' T-cells were more responsive to dexamethasone after they had taken the supplement. The test results were positive.

Dr Hawrylowicz said: 'This is a great example of how productive basic science collaborations can translate into studies in patients. Our research began more than five years ago with Dr Anne O'Garra from the MRC National Institute for Medical Research at Mill Hill.'

She added: 'At the moment we only have a preliminary experimental observation, that ingestion of vitamin D3 can increase the responsiveness of T-cells from patients with steroid-resistant asthma to steroids. We now need to test the benefits of this treatment in the clinic, and we are currently putting a proposal together to carry out this work.

'Interestingly, vitamin D3 is at present occasionally administered to patients with severe asthma to help prevent steroid-induced osteoporosis. Our studies suggest that there is an additional potential benefit to this treatment.'

Dr. Lyn Smurthwaite, Research Development Manager at Asthma UK said: '2.6 million people in the UK have severe asthma symptoms, many of whom have restricted treatment options available to them as they do not respond to conventional steroid therapy. Asthma UK is very pleased to have funded this research which opens up a potentially important new avenue for developing treatments for people with difficult to control asthma.'

Asthma is usually treated very effectively with inhaled steroids but for some patients, taking steroid tablets is the only way of controlling their condition, and this can cause considerable side effects. Unfortunately a sub-group of people with severe asthma fail to show clinical improvement, even with high doses of oral steroids, limiting their treatment options.

Professor Tak Lee, Director of the MRC-Asthma UK Centre in Allergic Mechanisms of Asthma at King's College London and Imperial College, who was involved in the latest study, explained its importance: 'This research is really exciting and points the direction towards potential new strategies for reversing steroid resistance. This has major implications for how to treat patients with severe asthma and could also substantially reduce the use of NHS resources.'

The team's results imply that steroid treatment works, at least in part, by inducing the T-cells of the immune system to synthesise a secreted signalling molecule, called IL-10. This molecule can inhibit the immune responses that cause the symptoms of allergic and asthmatic disease.
Unlike T-cells from healthy individuals, or patients that respond to steroids, T-cells taken from patients who are steroid resistant do not produce IL-10 when cultured in vitro with the steroid, dexamethasone.

However, the researchers found that when vitamin D3 was added to the culture medium along with dexamethasone, this defect was reversed and the previously steroid-resistant cells were able to respond to the treatment by producing IL-10 to the same extent as T-cells taken from steroid-responsive patients.

Adding vitamin D3 to cultures of T-cells from healthy individuals or from steroid-responsive patients made these cells even more responsive to steroids than before.

Dr Catherine Hawrylowicz, who led the King's research team said: 'The hope is that this work will lead to new ways to treat people who don't respond to steroid treatment as it currently stands, and it could also help those people who are on heavy doses of steroids to reduce the amount of medication they are taking.'

To test whether this therapy could work in practice the team at King's went on to perform a pilot experiment where people with asthma who were unresponsive to steroids took daily vitamin D3 supplements for seven days. The researchers took blood samples to assess whether the patients' T-cells were more responsive to dexamethasone after they had taken the supplement. The test results were positive.

Dr Hawrylowicz said: 'This is a great example of how productive basic science collaborations can translate into studies in patients. Our research began more than five years ago with Dr Anne O'Garra from the MRC National Institute for Medical Research at Mill Hill.'

She added: 'At the moment we only have a preliminary experimental observation, that ingestion of vitamin D3 can increase the responsiveness of T-cells from patients with steroid-resistant asthma to steroids. We now need to test the benefits of this treatment in the clinic, and we are currently putting a proposal together to carry out this work.

'Interestingly, vitamin D3 is at present occasionally administered to patients with severe asthma to help prevent steroid-induced osteoporosis. Our studies suggest that there is an additional potential benefit to this treatment.'

Dr. Lyn Smurthwaite, Research Development Manager at Asthma UK said: '2.6 million people in the UK have severe asthma symptoms, many of whom have restricted treatment options available to them as they do not respond to conventional steroid therapy. Asthma UK is very pleased to have funded this research which opens up a potentially important new avenue for developing treatments for people with difficult to control asthma.'

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Osteoporosis: A Deadlier Risk Factor For Coronary Disease

Here's one more reason you should optimize your health with exercise and diet to prevent osteoporosis: Patients who suffer from that painful, bone-thinning disease have an increased risk for coronary artery disease (CAD).

After testing more than 200 men and women over the course of a year, Michigan researchers found more than half of their patients had clear signs of CAD. The difference from previous studies: Patients were catheterized, allowing scientists to get a far better read on any blockages.

What's more, osteoporosis patients were six times more prone to have coronary disease than those who didn't. In fact, folks, osteoporosis was a stronger indicator of coronary heart disease than a family history of the disease, high blood sugar levels or elevated blood pressure.

Besides diet and exercise, getting the right amount of vitamin D is another natural weapon at your disposal to prevent osteoporosis and fight diseases like Parkinson's.

Yahoo News November 24, 2005

American Journal of Cardiology, Vol. 96, No. 8, October 15, 2005: 1059-1063