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Dear Brian,
Spring has finally arrived! At least here in the Bay Area, where
most of us are thrilled to finally see the sun after such a long,
wet and destructive winter. There are budding flowers
everywhere, lots of new green growth and of course, we’re
starting to see more and more varieties of organic produce in
the markets.
The asparagus, which arrives with the first signs
of spring, is reasonably priced and delicious. You’ll notice one
article this month featuring asparagus, how it's full of
nutritional punch and ideas for enjoying it in your meals.
As promised, I’m also addressing the negative news
reports about Calcium and Glucosamine/
Chondroitin supplements, in response to all the recent
questions about these reports.
I always recommend looking at actual study results
before making any changes based on something reported in the
media – whether it’s dietary or supplement
recommendations. And be sure to notice who sponsored,
paid for and is promoting the study. Hopefully you will notice
after reading this month’s newsletter, and last month’s as well
that the media does not have a good track record for
reporting accurately on study results related to diet and dietary
supplements.
Also, when it comes to supplements and lifestyle issues,
“one-size-fits-all", general recommendations from the media
may not be the best way to decide what is right or wrong for
you. I would be happy to consult with you on the best
customized approach for you based on what is happening in
your body, what your lab results are and how you feel. Call for an
appointment and we can get started just in time for
spring.
If you like what you read here, please feel free to
forward this newsletter to friends who might appreciate it
as well.
Feel free to direct your questions for future newsletters to
“Ask Judy” We’ll try and highlight those that have the most general
interest. Happy Spring!
| Should You Stop Taking Glucosamine for Your Joints? |
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There is an old joke I once heard that begins with a man
watching Jesus actually walk across a body of water.
The
man,
who as it turns out was no fan of Jesus, reported back to
anyone who would listen:
“It’s obvious to me
that
Jesus
can’t swim!”
This past February the New England Journal of
Medicine, reported on the GAIT (Glucosamine/Chondroitin
Arthritis Intervention Trial) study. The media reports, however,
seemed a little like our intrepid man above reporting on Jesus.
The story headlines read, “supplements did little to ease
arthritis”. Another exclaimed, “they (Glucosamine/Chondroitin)
are a waste of money”. The media actually distorted the
encouraging results of this study to make it appear that the
supplements were of little value. Here’s what actually
happened.
The GAIT trial compared 4 study groups – those
assigned Glucosamine by itself, Chondroitin by itself, the
combination of the two, and the drug Celebrex. The study
participants had mild to severe knee pain. The actual study
results clearly show that participants with moderate to
severe arthritis pain had a better (and statistically significant)
improvement when given the Glucosamine/Chondroitin
combination compared to placebo, and even better than the
COX-2 drug, Celebrex. This Glucosamine/Chondroitin
group showed a 24-26.4% improvement (the study standard
identified a 20% improvement as being effective). The
Celebrex was
only 10% better than placebo in the moderate to severe
arthritis group (and not statistically significant), yet the
media mostly ignored the fact that Celebrex was included in
this study.
The data that caused the negative media stories involved
the study subjects with mild knee pain. The scientists
noted that the differences between placebo and all the various
agents were relatively small. In this group, Celebrex performed
slightly better than the Glucosamine/Chondroitin group – but
none were statistically significant. While in the
moderate to severe group, the Celebrex benefit was still not
statistically significant, but the Glucosamine/Chondroitin was
very effective as stated above, By reporting only on the results
in the mild pain group the media took this opportunity to attack
the efficacy of Glucosamine/Chondroitin supplements without
even mentioning that Celebrex didn’t perform either.
Neither Glucosamine/Chondroitin nor Celebrex fared as
well as in other studies in the mild pain group, perhaps
because the placebo group improved by 60% in this
group (which is very high for a placebo group in any
study), and may explain why the improvements with all the
supplements and Celebrex were only slightly better.
In addition, there was also flaw in this study. The
researchers actually used the wrong form of Glucosamine.
They used Glucosamine hydrochloride, when in fact, it’s
Glucosamine sulfate that you’ll find in most of your
supplements. The “sulfur” in the sulfate form also has
beneficial anti-arthritic properties. Even with the less effective
form, the results proved statistically significant for the
Glucosamine/Chondroitin combination.
Reporting on the positive results of the GAIT study would
not have sold newspapers because there have been dozens
of studies substantiating the anti-arthritic and pain
relieving properties of Glucosamine and Chondroitin. These
supplements are among the top 10 most popular dietary
supplements sold in the U.S., and over 20 million Americans
are affected by osteoarthritis. Negative headlines about these
supplements would definitely get attention and sell papers.
I have to say again before you make changes in your diet or
supplement regimen based on study results reported in the
media, please go back to the actual study and real results.
And, also be sure to note who paid for, sponsored and/or
promoted the study to be sure there is no conflict of interest.
If you have joint pain, one approach would be trying
Glucosamine and Chondroitin. In my experience using these
supplements over many years in my practice, about 70-80% of
my clients have positive results. As always, supplements do
not work in a vacuum. They work synergistically with a
healthy
anti-
inflammatory diet and healthy life-style. As always
when
trying supplements for a particular purpose or symptom, I
recommend a
3-month trial. You should experience results within 2 weeks to
3 months with Glucosamine/Chondroitin. If there’s no benefit in
3 months, it won’t work for you, stop these supplements and
try a different approach. And, if you have limited benefit, there
are other supplements and herbs that we can add to greatly
improve effectiveness. There are many natural anti-
inflammatory and anti-arthritic options. If you’d like help
in creating a program to eliminate joint pain and keep you
enjoying your activities, call for a personalized
assessment.
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| Calcium Supplements Don't Build Bones - NOT! |
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Recent front-page news stories all over the country declared
that Calcium and Vitamin D supplementation were worthless
when it comes to preventing bone fractures. This is
irresponsible reporting, in my opinion, and it likely caused
millions of women to throw away their Calcium supplements.
But when you look at the actual study results, these reports
were dead wrong. Let’s take a second look at the study
results.
First of all, this study was extremely flawed. The
form of
Calcium used in the study (Calcium carbonate) is actually the
least favorable for absorption purposes. The dose of Vitamin D
used (400 iu) is not considered high enough for supporting
Calcium absorption and building bone density. And, the women
were not instructed to take Magnesium, Zinc and the other
essential nutrients for building optimal bone density. But
that’s
the least of this study’s flaws.
According to the study report, about 40% of the
women in the study group assigned to take the Calcium and
Vitamin D didn’t even take the supplement regularly.
And furthermore, the placebo group was allowed to
take any vitamins on their own, if they wanted. As it turns
out many of the women in the placebo
group were indeed taking Calcium and Vitamin D, even though
they were in the placebo study group. In addition, both groups
were allowed to take drugs like Fosamax, Calcitonin and
hormone therapies that are known to prevent bone loss and
maintain bone density. As you can see, this was a very
poorly designed study , and it is unheard of in the
scientific community
that a control placebo group would be allowed to actually take
the substances being studied.
And considering all this, the study still proved that the
women
who received Calcium and Vitamin D had a significant increase
in hipbone mineral density. According to the study results,
there was a 29% reduction in hip fracture in the women who
actually took the supplements at least 80% of the time.
But
that is not what was reported!
A study this poorly designed should not have made the
front
pages at all. But this is big news and sells papers! It is so
unfortunate that there was no investigation into what the actual
results were. And, at my most cynical, I’d say this kind of
reporting is great news for the pharmaceutical industry. After
all, there is a lot of profit to be made with drugs used to treat
osteoporosis.
Of course this is not to say that taking Calcium and
Vitamin D
are the only measures for maintaining a healthy bone
density.
In fact, taking Calcium with an unhealthy diet will provide very
limited benefit. It’s important to understand that Calcium works
synergistically with other minerals and nutrients to build bone.
And, they should be taken in the most absorbable forms, at the
right times and in the correct doses. In addition, a bone
building program starts with eating a healthy anti-inflammatory
diet, having a consistent exercise program
and
avoiding the
foods and beverages that produce an acidic environment which
accelerates the lose of Calcium from the bones. If you’d
like to
set up a bone-building program for you, call for an
appointment. We’ll set up a personalized program to help
you
eliminate the food and life-style “bone-busters” and
incorporate
the “bone-builders” so your prevention program has the best
chance of working for you.
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Fresh Asparagus is In-Season
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I often hear clients and friends say they are bored with
eating
the same foods all the time. But Mother Nature provides us
with a seasonal variety, and I always mark the beginning
of
each new season with something delicious that only grows that
time of year. For me, the first sight of asparagus in the
markets means springtime is here. Of course, each month of
the year nature continues to provide new and colorful choices
for our dinner table. The combination of eating organic and
in-season ensures not only the most nutritious,
but also the
tastiest foods, as well as natural variety. I made the mistake of
buying the first organic strawberries that showed up in the
market about 2 months early – and I was sorry when I tasted
them. If we wait for nature’s natural timing and bounty –
we’re
rewarded with richness in taste.
Also, here are two additional bonus benefits from eating
this
way: First, you won’t be encouraging the practice of
wasting
petrol by shipping “out of season” foods from hundreds, and
sometimes thousands of miles away. And secondly, if
you buy
from your local farmers market, you’ll usually be supporting a
small, local farmer. OK, back to amazingly delicious, in-
season asparagus.
Asparagus is rich in nutrients. It’s high in
potassium and is an
excellent source of B vitamins, especially folic acid. It’s high in
fiber, one cup providing a whopping 5 grams of fiber (1/4 of the
minimum daily requirement). It’s abundant in glutathione,
which is a powerful anti-oxidant and plays a critical role in
helping our bodies detoxify from chemicals, heavy metals and
certain carcinogens.
Asparagus is easy to prepare. You just wash
and trim the
spears, by snapping off the ends where they naturally break
when you bend them. Or, you can peel the bottom half with a
vegetable peeler to make the entire spear edible.
4 Ways to Enjoy It:
Raw: slice the tips and only the tender
stalks, very thinly on
the diagonal and add to salads.
Steamed: place asparagus in a steam
basket over boiling water
for 3-4 minutes, or until al dente (softer, but still firm).
Remove and drizzle with freshly squeezed lemon juice,
vinaigrette, or with olive oil and some chopped fresh mint or
tarragon. For a special treat, sprinkle a little parmesan cheese
on it.
Grilled: arrange the raw asparagus in an
even layer in a baking
pan. Drizzle with a little olive oil and roll the asparagus spears
around to coat them. Add a little ground pepper and sea salt to
taste, as you like. Place in oven at 450 degrees for about 15
minutes. Of course depending upon the weather, you can grill
them outside as well. A grilling basket can be a big help here,
preventing the asparagus from slipping into the fire.
Stir-fried: Cut into bite-size pieces on
the diagonal and add to
any stir-fry.
So there you have the scoop on asparagus! Enjoy, It’s only
in-season for a short while.
Info to set up an appointment....
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