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We have been told all our lives to drink milk for strong bones. Eat more yogurt and cheese. And to be sure we are getting enough calcium to protect our bones, take a calcium supplement.

This thinking is based on the fact that osteoporotic bone contains less calcium than healthier bone and dairy products have lots of calcium per serving, so the logical conclusion is to drink milk and eat dairy products to get more calcium into the body.

So as a nation, we have increased our overall calcium and dairy intake; however, at the same time our osteoporosis rates are skyrocketing? If milk and supplemental calcium are the answer, shouldn’t hip fractures rates be declining?

Many are questioning this advice and with thorough testing and research they are advancing additional theories.

The highest rates of hip fractures are in Western countries:  North America, Europe –especially northern Europe, Australia and New Zealand.  Hip fracture is much less of a problem in Africa, Asia and South America.

Calcium consumption in the United States and Western Europe averages about 1,000 milligrams a day, whereas in China, Peru, Sri Lanka and other non-western countries, calcium consumption  is only about 500 milligrams a day, yet fracture rates are very low.

Currently 10 million Americans over age fifty have osteoporosis – 8 million women and 2 million men.  Another 34 million have osteopenia (bone and mineral density considerably below normal).  Each year 1.5 million Americans suffer an osteoporotic fracture.

One of the most interesting and convincing  programs  recommended to prevent bone loss is the low-acid or vegan diet.  In Building Bone Vitality* the authors over many years have directed and reviewed many clinical trials regarding bone health.  They conclude that the vegan or low-acid diet is the best answer to prevent osteoporosis. They explain that bone health begins in the blood.

  • More than 99 percent of the body’s calcium is found in teeth and bones.
  • Bone is approximately 40 percent calcium.
  • As osteoporosis develops, bone mineral density (BMD) declines.
  • Blood transports oxygen and many nutrients to every cell.
  • Blood collects metabolic wastes and delivers them to the lungs, kidneys, liver and digestive tract for elimination.

They explain that the blood self-regulates its acidity and alkalinity -its pH.  As Hydrogen ions increase, the solution is more acidic.  In review, the pH scale ranges from 0 to 14.  A neutral solution – neither acidic or alkaline (basic) – has a pH of 7. A pH below 7 means the solution is acidic and a pH above 7 is alkaline.  Blood is slightly alkaline.  Its normal pH varies from 7.35 to 7.45. If the blood’s pH falls below 7.35 or rises above 7.45 the body does not function properly and the body expends considerable energy to keep the blood’s pH within normal range.

Milk and dairy foods contain calcium and also contain protein. Proteins are combinations of 20 amino acids.  Digestion breaks proteins into their component amino acids and sends them into the blood stream.  The more protein in the diet the more amino acids enter the blood stream.  A high-protein diet reduces the blood’s pH. The body takes steps to raise the blood’s  pH.    Calcium is alkaline. So when the blood needs alkaline to neutralize the acid, it can find calcium in the bones and draws the calcium compounds out of bone into the blood to neutralize the blood.  This then reduces the amount of calcium in the bone.  As this occurs more calcium is drawn into the blood than is needed.  The kidneys then filter the excess calcium into the urine.  The National Academy of Sciences says that 1 gram of dietary protein increases urinary calcium excretion by 1 to 1.5 mg.  Thus if an individual eats a four ounce serving of meat, which contains about twenty grams of protein, one then loses twenty to thirty milligrams of calcium.  Over a lifetime, if this loss is not returned to the bones, the loss is significant and osteoporotic fractures can occur.

Many believe that it is not possible to get enough calcium for strong bones without milk and dairy foods.  However they do not realize how much calcium can be obtained from fruits and vegetables and that about one-half to two-thirds of the calcium in dark green leafy vegetables gets absorbed, whereas less than a third of the calcium in milk and dairy is absorbed by the blood stream.  In addition plant foods are alkaline, so they do not force the body to draw calcium from the bones.

In the United States the recommended calcium intake is 1000 mg/day.  Residents of many countries around the world consume less than 500 mg of calcium per day and have substantially lower fracture rates than Americans.

Sources of calcium:

Mg Calcium

Tofu, firm, 1 cup                                  506

Soy milk, calcium fortified, 1 cup          368

Collard greens, cooked, 1 cup              356

Spinach, cooked, 1 cup                        292

Figs, 10 dried                                      269

Turnip greens, cooked, 1 cup               248

Fortified-ready-t-eat cereals, 1 oz      236 – 1,043

Soy milk, calcium fortified, 1 cup         368

Thus the authors are saying, -to save your bones, eat a low-acid or vegan diet.

We need to eat some calcium, but much less than recommended.  The best sources are greens and beans.

They say – Eat two servings of fruit and/or vegetables at every meal and snack on fruit and vegetables.  Cut down on, or reduce animal foods and go easy on cereals, breads and pastas.  Pair this with walking (or other weight-bearing exercise) for at least a half hour a day from childhood to old age and your risk of osteoporotic fractures is reduced by 50 percent, a decrease most osteoporosis drugs can’t match.*

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  • Lanou, Amy Joy, Ph.D., and Castleman, Michael, Building Bone Vitality, McGraw Hill, 2009.

 

 

 

 

 

 

 

 

Creatine

Creatine is a chemical that is normally found in the body, mostly in muscles. It is made by the body, from the amino acids glycine and arginine, and is made primarily in the kidney and liver and is transported by the blood to the muscles and stored. It is also obtained from certain foods – mostly fish and meat.

Creatine helps to supply energy to all cells in the body and primarily to muscle. This is done by converting creatine into creatine phosphate or phosphocreatine and then into adenosine troposphere (ATP). ATP produces the contractions of a muscle’s proteins. When muscles are performing work ATP is broken down into ADP (adenosine diphosphate) and energy is given off.

The concentration of ATP in skeletal muscle is enough to result in a muscle contraction of only a few (10-15) seconds. Fortunately during times of increased energy demands, the system rapidly resynthesizes ATP from ADP. Creatine acts as a reserve for the ATP. Thus the increased amounts of creatine will allow the body to supply ATP as a faster rate. This allows the individual to workout longer and maintain a high level of strength. (With creatine as a supplement the body is exposed 4 grams of creatine per kilogram whereas red meats give 1 gram of creatine per large serving.)*

Creatine supplements are popular among athletes, bodybuilders, wrestlers, sprinters and others who wish to gain muscle mass and enhance athletic performance, particularly during high-intensity, short-duration sports like jumping and lifting weights. There is some evidence supporting the use of creatine in improving the athletic performance of young, healthy people during brief high intensity activity.

Many think creatine is effective for athletic performance. The effectiveness is influenced by several factors including the fitness level and age of the person, the type of sport and the dose. It does not seem to improve performance aerobic exercises or benefit older persons, or highly skilled athletes.**

Neither the National Collegiate Athletic Association (NCAA) or the International Olympic Committee have banned its use, although there is controversy.***

Vegetarians and other people who have lower total creatine levels when they start taking creatine supplements seem to get more benefit than people who start with a higher level of creatine. Skeletal muscle will only hold a certain amount of creatine; adding more won’t raise levels any more. This “saturation point” is usually reached within the first few days of taking a “loading dose”.**

Not all studies have shown that creatine improves athletic performance, nor does every person respond in the same way. ***

Studies have shown little or no adverse impact on kidney or liver function from oral supplementation and that oral creatine supplementation of a rate of 5-20 grams per day appears to be safe and devoid of adverse side-effects. ****

However there is always the potential for side effects and interactions with medications. Therefore dietary supplements should always be taken only under the supervision of a knowledgeable health care provider. Side effects can include weight gain, muscle cramps and pulls, stomach upset, diarrhea, dizziness, high blood pressure, liver dysfunction and kidney damage. Some persons may gain weight. This is because creatine causes the muscles to hold water, not because it is actually building muscle.

There is some concern that creatine supplementation can harm the kidney, liver or heart function. However such effects have not been proven.

Creatine causes muscles to draw water from the rest of the body and causes minor water retention. This can also cause dehydration. Also do not exercise in the heat as one can become dehydrated. Thus WHILE CREATINE IS BEING TAKEN IT IS NECESSARY THAT THE INDIVIDUAL REMAINS HYDRATED.

It is recommended that persons with kidney or liver disease should not use this supplement. Also persons with asthmatic symptoms should use caution. It is advised that pregnant and breastfeeding person should not use creatine as there has not been sufficient study. If there should be problems with metabolizing creatine, this has shown to cause low levels of creatine in the brain which can result in mental retardation, seizures, autism and movement disorders. * There has not been a lot of long term, unbiased, research done with this product and in such instances, it is sometimes advisable to proceed with caution.

There has been some mention that with creatine’s ability to increase muscle mass and strength, that it may help fight muscle weakness in illnesses such as heart failure and muscular dystrophy. Much more work needs to be done in this area.

(To clarify – Creatinine is a breakdown product of creatine and is produced by the body. It is a chemical waste product produced by muscle metabolism and to a smaller extent from eating meat. Healthy kidneys filter creatinine and other waste products from the blood. A creatinine lab test is done to learn how well the kidneys are functioning. An increase of creatinine in the blood means that the kidney is not functioning well.)

 

 

 

 

* Hogans, Tavarus, Creatine Monohydrate, Psychology Department, Vanderbilt University.
** Web MD, Creatine
*** University of Maryland, Creatine
**** Wikipedia – Creatine

 

 

 

 

 

Dr-older  “Food is the most underutilized weapon we have against chronic disease.
Knowing more about what’s in your food and how it got there, can help you take your health into your own hands. Culinary medicine is a new evidence-based field that blends the art of food    and cooking with the science of medicine and is aimed at helping people reach good personal medical decisions about accessing and eating high quality meals that can prevent and treat disease and enhance well-being.” *

So says John La Puma, M.D. ** Dr. La Puma thinks that the food one eats is an important part of the person’s health and ought to be considered in all treatment plans. He thinks that all clinicians should have training in culinary medicine.
“ ..the foods you use as fuel and which get stored as fat, can all now be beamed to you (or your coach, if you choose). You can now see in real time, what you are doing to make yourself healthy and conversely what you’re doing to make yourself sick.

“The obesity solution he likes best is one that makes wellness fun. Mobile technology, tracking companies, and game creators are coming together to do this . The most innovative companies today are developing ways to send to your mobile device your most relevant data – food and beverage intake, activity, weight, sleep, stress response – and combine it with game-like managed competition. The objective is to entice you to compete with your social network for the healthiest lifestyle and be rewarded along the way with ongoing coaching and other incentives.

“Heart rate, blood pressure, and glucose levels will soon follow. Devices and apps are changing the landscape of how people can get healthy.

“Clinicians should be able to recommend trusted apps, devices and websites, write culinary medicine prescriptions, and know how food, like medicine, works in the body.

“Clinicians should be able to offer condition-specific food and lifestyle measures, with tech-enabled tracking support, if desired, before recommending prescription medication for most chronic conditions.

“A new consciousness about the power of food and cooking, combined with ever-advancing mobile technology, can put care back where it belongs, in the patient’s own hands.” *

Doctors learning nutrition – GREAT! Yes, the food we eat is an important part of our health and combining the information with today’s technology and then sending the information to our mobile devices so that we can see and utilize the information immediately. What technology!

The benefits of this would be immeasurable. However it must be done correctly. Misinformation about foods could destroy the effectiveness. Food fads, and over-emphasis, positive or negative, on some foods could have undesirable results.
“Everything in moderation”.

There should also be caution to use such information together with the insight and knowledge of a trained professional. A little knowledge can sometimes not be good. Even the latest scientific findings can be found to be incorrect, when in a few years, additional research reverses or limit’s the findings of earlier research.

And we ought always remember that, although food is nutrition, food should also be enjoyed. We eat foods at parties and celebrations for the “fun” of it and we enjoy someone’s casserole or dessert, because they have put much time and work into preparing it and because it tastes good. So if a food’s sodium level is a bit high or the saturated fat content is a couple grams over, unless, the individual is in the hospital bed and connected to a monitor, perhaps, we can go “light” on the criticism for the occasion.

However this concept of culinary medicine, could not only be beneficial but also a lot of fun.Dinner Place Setting

 

 

 

 

 

 

 

 

 

 
* Nutrition Close-UP, Egg Nutrition Center, Winter 2015.
** John La Puna, MD is a board certified practicing internist, a professionally trained chef and New York Times bestselling author : Chef MD’s Big Book of Culinary Medicine, Visit online at drjohnlapuna.com

 

 

 

 

 

 

 

 

 

Soup, bowl

Soup, bowl 2 A bit of trivia today.  With the colder weather I have been thinking about soup.  I love homemade split pea, bean, vegetable soup and chili.  So while  surfing the net, I clicked on “soup” and from Wikipedia I learned some facts I didn’t know and will pass on to you – maybe you don’t know, either!

“The word soup comes from French soupe (“soup”, “broth”), which comes through Vulgar Latin suppa (“bread soaked in broth”) from a Germanic  source, from which also comes the word “sop”, a piece of bread used to soak up soup or a thick stew.

“The word restaurant (meaning “[something] restoring”) was first used in France in the 16th century, to refer to a highly concentrated, inexpensive soup, sold by street vendors, that was advertised as an antidote to physical exhaustion. In 1765, a Parisian entrepreneur opened a shop specializing in such soups. This prompted the use of the modern word restaurant for the eating establishments.

“In the US, the first colonial cookbook was published by William Parks in Williamsburg, Virginia, in 1742, based on Eliza Smith’s The Compleat Housewife; or Accomplished Gentlewoman’s Companion and it included several recipes for soups and bisques. A 1772 cookbook, The Frugal Housewife, contained an entire chapter on the topic. English cooking dominated early colonial cooking; but as new immigrants arrived from other countries, other national soups gained popularity. In particular, German immigrants living in Pennsylvania were famous for their potato soups. In 1794, Jean Baptiste Gilbert Payplat dis Julien, a refugee from the French Revolution, opened an eating establishment in Boston called The Restorator, and became known as “The Prince of Soups”. The first American cooking pamphlet dedicated to soup recipes was written in 1882 by Emma Ewing: Soups and Soup Making.”*

 

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Even “In Ancient Greece and Ancient Rome, thermopolia (singular thermopolium) were small restaurant-bars that offered food and drinks to customers. A typical thermopolium had little L-shaped counters in which large storage vessels were sunk, which would contain either hot or cold food. Their popularity was linked to the lack of kitchens in many dwellings and the ease with which people could purchase prepared foods. Furthermore, eating out was considered a very important aspect of socializing. (Kind of like today!)

“In Pompeii, 158 thermopolia with a service counter have been identified across the whole town area. They were concentrated along the main axis of the town and the public spaces where they were frequented by the locals.

“In China, food catering establishments which may be described as restaurants were known since the 11th century in Kaifeng, China’s northern capital during the first half of the Song Dynasty (960–1279). Probably growing out of the tea houses and taverns that catered to travellers, Kaifeng’s restaurants blossomed into an industry catering to locals as well as people from other regions of China. Stephen H. West argues that there is a direct correlation between the growth of the restaurant businesses and institutions of theatrical stage drama, gambling and prostitution which served the burgeoning merchant middle class during the Song Dynasty. Restaurants catered to different styles of cuisine, price brackets, and religious requirements. Even within a single restaurant much choice was available, and people ordered the entree they wanted from written menus. An account from 1275 writes of Hangzhou, the capital city for the last half of the dynasty:  ‘The people of Hangzhou are very difficult to please.

Hundreds of orders are given on all sides: this person wants something hot, another something cold, a third something tepid, a fourth something chilled; one wants cooked food, another raw, another chooses roast, another grill.”  (Again, sort of like today!)

“In the Western world, while inns and taverns were known from antiquity, these were establishments aimed at travelers, and in general locals would rarely eat there…. The modern idea of a restaurant – as well as the term itself – appeared in Paris around 1765.”  At that time, Boulanger, a soup vender, began to sell “restaurants” and other foods.  Certain soups were known as restaurants –literally “restoratives”.

“The Encyclopédie defined restaurant as “a medical term; it is a remedy whose purpose is to give strength and vigor.” Thanks to Boulanger and his imitators, these soups moved from the category of remedy into the category of health food and ultimately into the category of ordinary food….Almost forgotten in the spread of restaurants was the fact that their existence was predicated on health, not gustatory, requirements.”

“Restaurants became a type of eating establishment, where one can order a meal from a range of choices at a range of times and eat it on the premises.

Restaurant

“In the United States, it was not until the late 18th century that establishments that provided meals without also providing lodging began to appear in major metropolitan areas in the form of coffee and oyster houses. The actual term “restaurant” did not enter into the common parlance until the following century. Prior to being referred to as “restaurants” these eating establishments assumed regional names such as “eating house” in New York City, “restorator” in Boston, or “victualing house” in other areas. Restaurants were typically located in populous urban areas during the 19th century and grew both in number and sophistication in the mid-century due to a more affluent middle class and to suburbanization.” *

 

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  • Wikipedia, “soup,” “restaurants”

 

 

 

 

 

 

 

 

 

 

Chromium_picolinate

Chromium is an essential mineral that is not made by the body and must be obtained from the diet.

Chromium is important in the metabolism of fats and carbohydrates.  It stimulates fatty acid and cholesterol synthesis, which are important for brain function and other body processes and is important in the breakdown (metabolism) of insulin.

Chromium deficiency may be seen as impaired glucose tolerance. It is seen in older people with type 2 diabetes and in infants with protein-calorie malnutrition.

 

Recommended daily intake:

Age:      (micrograms per day)           Males      Females      Pregnancy          Lactation

0 to 6 months      0.2

7-12 months         5.5

1-3 years              11

4-8 years              15

9-13 years       . . . . . . . . . . . . . . . . .           25               21

14-18 years    . . . . . . . . . . . . . . . . . .          35              24                 29                      44

19-50 years     .  .  .  .  .  .  .  .   .  .  .  .          35              25                30-                     45

50+ years        .  .  .  .  .  .  .  .  .   .  .  .          30              20

 

Chromium is widely distributed in the food supply, but most foods provide only small amounts – less than 2 micrograms (mcg) per serving.

Selected food sources of chromium:

Broccoli, ½ cup    –    –   –      11  (mcg)

Potatoes mashed -1 cup .        3

Beef cubes, 3 ounces    .   .      2

Turkey Breast, 3 oz  .   .    .     2

Whole Wheat bread, 2 slices    2

Apple, 1 medium  .   .   .   .       1

The best source of chromium is brewer’s yeast.  Other good sources include: beef, liver, eggs, chicken, oysters, wheat germ, green peppers, apples, bananas, spinach.

 

Absorption from the intestinal tract is low ranging from less than 0.4% to 2.5% of the amount consumed. The remainder is excreted from the body.

The body’s chromium content may be reduced under several conditions.  Diets high in simple sugars can increase chromium excretion in the urine.  Infection, acute exercise, pregnancy and lactation and stressful states (such as physical trauma) can increase chromium losses and lead to deficiency.  However chromium deficiency in humans is rare.

 

There is some interest that suggests that older adults may be more vulnerable to chromium depletion. Chromium research has been of interest in the treatment of diabetes, in lowering lipid levels and promoting weight loss and in changing body composition from fat to lean muscle mass.  However results are yet inconclusive.

Few serious adverse effects have been linked to high intakes of chromium, so there has been no Tolerable Upper Intake Level established.  However the increased intake of any substance beyond normal limits, should be done with a physician’s consult.

As with all nutrients the best means is to eat a balanced diet.