The Pill May Decrease Bone Density

Recent Study shows that Oral contraception may decrease bone density in young women.

Those taking birth control pills for more than two years, and those on the low-dose estrogen pills appear to have the greatest risk of decreased bone density in the spine and whole body, according to the researchers.

"I think the evidence is still emerging on this association, but our findings suggest that low-dose oral contraceptives with long-term use have some impact on bone density," said study author Delia Scholes, a senior investigator at the Group Health Research Institute of Group Health Cooperative in Seattle.

The findings were published in the January issue of Contraception.

What isn't entirely clear from this study of women under 30, explained Scholes, is what the long-term impact might be. Researchers don't know if the lower bone density findings are easily reversible just by stopping the use of oral contraceptives. They also weren't able to study if the lower bone density in these young women would translate to a higher fracture risk later in life.

But, "if oral contraceptives are indeed causing the approximately 5 percent lower spine bone density for oral contraceptive users versus non-users that we observed in our study, and if that impact is not reversed with oral contraceptive discontinuation or with other factors that may occur across the life span, a 5 percent lower bone density after menopause is associated with approximately 50 percent more osteoporotic fractures," said Scholes.

Almost 12 million American women are currently using oral contraception, according to background information in the study. And, the use of oral contraception is highest in women under 30, reports the study. That's important because the 20s are generally a time of peak bone mass production.

However, little is known about the effects of oral contraception on bone density. Previous studies have had conflicting results, with some showing no effect or a benefit on bone density while others suggest that oral contraceptives may inhibit bone mass accrual.

The current study was comprised of 606 woman between the ages of 14 and 30. The researchers reviewed oral contraceptive use, the duration of use and the estrogen dose in the contraception, and compared this to bone mineral density tests. The bone density test measured bone density in the hip, spine and whole body.

When the researchers compared oral contraceptive users to non-users they found that women taking oral contraception had average bone mineral density levels that were 5.9 percent less for the spine and 2.3 percent lower for the whole body. There was a trend for lower bone density in the hip as well, though this trend didn't reach statistical significance.

The researchers also noted a trend toward lower bone density in women taking oral contraceptives containing lower doses of estrogen, with the lowest readings in women taking formulations containing less than 30 micrograms of estrogen.

The researchers found no effects in the 14- to 18-year-old age group. However, Schole said it's important to note that contraceptive use was less in this age group than for the women between 19 and 30.

Scholes said the researchers suspect that the hormones in birth control pills are likely affecting normal hormone levels -- perhaps lowering normally circulating estrogen levels -- which then affects bone production.

"The studies on oral contraception and bone density have been conflicting," said Dr. Beatrice Chen, director of the Center for Family Planning Research at Magee-Women's Hospital at the University of Pittsburgh Medical Center. "Although this study adds to that information, I don't think young women should be scared into stopping birth control. Talk with your doctor about your own risk factors, and the risks and benefits of using oral contraception."

Chen said that studies on longer-term birth control, such as Depo-Provera, have shown that when the contraception is stopped, bone levels quickly return to normal.

If you're concerned about your bone health, Chen said that there are steps you can take to help prevent bone loss, including: consuming adequate calcium and vitamin D, participating in weight-bearing exercise and quitting smoking.

More information

Learn more about your bone health from the National Institute of Arthritis and Musculoskeletal and Skin Diseases.



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Study Confirms Benefits of Vitamin D and Calcium for Bone Strength

A new study has proven that nutritional supplements such as vitamin D and calcium can prevent bone fractures, a practice many physicians have been recommending for quite some time.

Research conducted at UC Davis in Sacramento, California, revealed that individuals who take the nutritional supplements on a daily basis reduces the risk of bone fractures regardless of gender and age.

The findings represent a large effort from researchers around the world, determining the benefits of calcium and vitamin D in post-menopausal women, adult men and younger patients of both genders.

Various reports have confirmed that the supplements help post-menopausal women prevent osteoporosis, which affects roughly 8 million American women.

The researchers discovered that combining both of the supplements provides better results than when they are taken separately.

"This combination of supplements benefits both women and men of all ages, which is not something we fully expected to find," explained co-author John Robbins, a professor at UC Davis. "We now need to investigate the best dosage, duration and optimal way for people to take it."



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Milk Strike

Infant Feeding

Health experts say the best source of nutrients for a baby is breast milk. Breastfeeding has benefits for the baby and for mom. For the baby, breast milk contains the right amount of nutrients to support the infant’s growth and development. For the mom, breast milk is readily available (no mixing formula or heating bottles). Breastfeeding also provides a close bond between mom and baby.

The American Academy of Pediatrics recommends breastfeeding until a baby is at least six months old. Women who don’t breastfeed can use iron-fortified infant formula. At about four to six months, many infants can be introduced to baby cereals. Other baby foods are slowly offered starting around six months.

Milk is an important source of nutrition for children as they grow older. It provides calcium, vitamin D and minerals needed by the body. Whole milk is recommended for most children until they reach two because most children need the extra fat and calories. After two, parents can switch to low-fat or nonfat milk.

Experts warn parents should avoid giving cow’s milk until a child reaches his/her first birthday. Tyrala says cow’s milk is a great source of nutrition for calves, but not for humans. A baby’s digestive system can’t handle the extra protein in cow’s milk. Adding it too early to a child’s diet can cause liver and kidney damage and increase the risk for an allergic reaction.


Transition Troubles

Most children take the change from breast milk or formula to cow’s milk in stride. But sometimes babies become very fussy and don’t want to accept cow’s milk. Occasionally, a baby will refuse to drink cow’s milk and go on a “milk strike.”

Eileen Tyrala, M.D., Pediatrician at St. Christopher’s Hospital for Children in Philadelphia, says taste is probably the biggest obstacle for babies when parents try to transition to cow’s milk. Human milk and formulas are much sweeter than cow’s milk and there are differences in the thickness and temperature of the milks. For breastfed babies, the change to a bottle or cup can trigger a loss of bonding associated with breastfeeding.


Tyrala offers some tips for parents who are having trouble with infants on a “milk strike”:

•Offer cow’s milk in a sippy cup. This helps the baby make the association between the new drink and the different taste and texture.

•Go slowly. If the child is very resistant to the change, try just one serving of cow’s milk a day. Then gradually increase the number of servings of cow’s milk. It can take several days to two weeks for the child to reach the goal of drinking all cows’ milk.

•Dilute the familiar drink. Use three parts breast milk or formula to one part water. This will slightly alter the taste and texture of the “familiar” drink and, hopefully, enable the child to gradually accept a different drink (cow’s milk). Tyrala says it should only take a few days for a child to accept cow’s milk using this technique, so the temporary loss of calories won’t have any great affect on the infant.

•Add some low-sugar flavor. Tyrala doesn’t like the idea of adding sugar-laden flavorings to make cow’s milk as sweet as formula or breast milk. If taste appears to be an issue, she suggests adding powdered flavorings with less sugar.

•Try a substitute. Try an alternative to cow’s milk, like soy milk, rice milk or potato milk. Make sure these substitutes are pasteurized and are supplemented with calcium and vitamin D. If a child continues to refuse to drink cow’s milk, try yogurt, soft cheeses or calcium fortified orange juice.

If you have any specific questions or concerns about feeding your children, talk with your health care provider. For general information:

• American Academy of Pediatrics

• National Institute of Child Health and Human Development

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Winter Back Pain? Low Vitamin D May Be to Blame

Is it possible that your chronic winter backache could be due to the lack of sun exposure during the fall and winter months?

Based on a review of research by Stewart Leavitt, PhD, Executive Director of Pain Treatment Topics, vitamin D may be just the “pain pill” your body is looking for.

Leavitt found that patients with chronic back pain usually had inadequate vitamin D levels. And when they were given adequate vitamin D supplementation, their pain either vanished or was significantly relieved.

This could be a simple solution to years of nagging pain. Get your D levels checked and if they’re low, start supplementing. Work with your doctor to see just how much vitamin D it takes to get your levels in the optimum range. Experts consider 30 to 60 ng/ml of 25-hydroxyvitamin D as the preferred range.

Dr Leavitt’s report, "Vitamin D: A Neglected 'Analgesic' for Chronic Musculoskeletal Pain," which was peer-reviewed by a panel of experts, includes important points, for instance:

While many people suffer from chronic back aches and soreness during the winter, many times there doesn’t seem to be any injury, disease or bone problem to justify it.

In a study of 360 patients with chronic back pain, all of them were found to have inadequate levels of vitamin D. After taking vitamin D supplements for 3 months, symptoms were improved in 95% of the patients.

Vitamin D is essential for calcium absorption and bone health. Among other things, inadequate vitamin D intake can result in a softening of bone surfaces, called osteomalacia, which causes pain. The lower back seems to be particularly vulnerable.

You may know that current suggested intake of vitamin D (600 IU a day) is outdated. Many people need much more, especially during late fall and winter in the northern regions of the world. Vitamin D is safe in doses up to 10,000 IU a day (and some experts say much more) and has few interactions with medicines. It’s very inexpensive and certainly worth a try.

Of course that doesn’t mean you should take vitamin D and forget about exercise, stretching, good posture, or that you won’t need some additional analgesic for your particular pain problem. But it’s certainly a healthy road to travel. It won’t irritate your stomach or damage your liver, like some pain medications. And there are so many other benefits associated with maintaining optimal levels!

The Anti-Aging Bottom Line: We’re seeing more and more benefits of maintaining optimal vitamin D levels, particularly during the fall and winter when many people don’t get enough sun exposure to make their own vitamin D. A nagging backache may be your body’s warning that your levels are low. Commonly recommended dosages range from 1,000 to 5,000 IU a day. A specific blood test for the major circulating form of vitamin D, 25-hydroxyvitamin D, can show how well your dosage is working.



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We need our place in the sun, too

While it is important to protect the skin from the sun and the melanomas which can result from over exposure, it is also critical that people understand the many benefits of vitamin D - the production of which is stimulated by ultraviolet radiation.

Exposure to the sun is known to be responsible for the initiation of melanoma and other skin cancers.

In New Zealand we have the highest rates of death from melanoma in the world because our temperate climate means being out in the sun is taken for granted.

To reduce the incidence of melanoma and other cancers a trendy mantra - slip, slop, slap and wrap - was introduced and SunSmart advice provided in schools.

Most could see the logic, were captivated and assiduously followed the recommendations.

But have the consequences been fully understood? Is the advice taken too diligently? Recently I saw a television advertisement for a product containing SPF 80+! Dunedin and Invercargill have 75% of the sunshine per year that Christchurch, Auckland and Wellington do.

We have a cooler climate, so there aren't as many days when it's comfortable to be out in the sun and besides there's shopping, DVDs and computers keeping us indoors and to make life more comfortable we're even planning to build a covered stadium!On the other hand, the sun's ultraviolet radiation promotes the synthesis of vitamin D in the skin so not getting enough time in the sun leads to low levels of vitamin D.

The sun is our main source of vitamin D because the few foods that contain vitamin D, like oily fish and eggs, provide only a small amount.

So it is important for everyone to have regular safe sun exposure.

Because vitamin D is fat soluble, what is made in the summer can be stored for the winter months, when it is colder and being out in the sun is less inviting, but that means it's imperative to be exposed to the sun when appropriate during the summer.

Vitamin D has an important role in maintaining blood calcium and phosphate levels by enhancing absorption of these minerals to promote bone formation and the production of strong healthy bones.

Low levels of vitamin D have been linked to reduced immunity, cancers, autoimmune disorders, diabetes, cardiovascular disease, schizophrenia, depression and autism.

Even now there are pleas for more funds to publicise the danger of being out in the sun.

But let's be rational - while keeping the danger of overexposure to the sun in mind, in the South it is essential to spend some time out in the sun.

Enjoy.

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'The Biggest Loser' Champ Lives Well With Milk

Losing has never felt so good for "The Biggest Loser" Danny Cahill. Danny knows maintaining his healthy new lifestyle means continuing to make smart choices everyday to help him stay fit. Drinking fat free milk is one healthy choice that is an important part of living well. And it's a simple step everyone can take. Every glass of milk has nine essential nutrients like protein for lean muscle, potassium to help maintain normal blood pressure, and calcium and vitamin D for strong bones.

Danny's ad copy reads, "Losing never felt better. Loving the new me means making smart choices every day. That's why I drink fat free milk. Every glass is packed with 9 essential nutrients including protein that helps keep me fit and strong. Now that's a winning combo."

Check out Danny's new ad, exclusive behind-the-scenes videos, photos from his Milk Mustache shoot and more at whymilk.com.

About the National Milk Mustache "got milk?®" Campaign

The Milk Processor Education Program (MilkPEP), Washington, D.C., is funded by the Nation's milk processors, who are committed to increasing fluid milk consumption. The National Fluid Milk Processor Promotion Board, through MilkPEP, runs the national Milk Mustache "got milk?®" Campaign, a multi-faceted campaign designed to educate consumers about the health benefits of milk. For more information, go to www.whymilk.com. Lowe New York is the creative agency for The National Milk Mustache "got milk®" Campaign.

SOURCE Milk Processor Education Program

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Formula for health is not in the vitamin aisle

It's estimated that 40 per cent of Canadians take vitamin and mineral supplements each day. Yet according to a report in the December issue of the Journal of the American Dietetic Association, the formula for optimal health isn't in the supplement aisle of a health-food store.

Instead, the best strategy for staying healthy and lowering your risk for heart disease, diabetes and certain cancers is to eat a wide variety of nutrient-rich foods – a practice that for many people is not a habit.

Still, the report recognizes that some people do require vitamin and mineral supplements. Knowing which ones to take – and how much – can be confusing.

The fact is, the maintenance of good health is related more to the types and amounts of foods you eat than to the amount of certain vitamins or minerals you consume. When obtained from foods, certain nutrients have been demonstrated to guard against a number of health conditions. But studies investigating the effect of supplements on health outcomes have turned up disappointing results.

Foods are complex, providing more than just a single vitamin or mineral. Plant foods such as fruits, vegetables, legumes, nuts and whole grains also contain fibre, along with hundreds of disease-fighting compounds called phytochemicals. It's thought that vitamins and minerals work in concert with other components of food to exert health benefits.

You've heard it over and over: Choose mainly whole grains, get seven to 10 daily servings of fruit and vegetables, eat beans and lentils more often, and so on. Yet a very small percentage of Canadians lives by Canada's Food Guide.

According to national survey data, Canadians of all ages don't get enough magnesium, folate or potassium from their diet. Most adults don't get enough calcium from foods. And women under 50 consume too little iron.

While it's ideal to try to meet your daily nutrient requirements from food, for some people this is hard to do. Pregnant women, nursing mothers, strict vegetarians, people with food intolerances and allergies, and elderly adults often need to fill dietary gaps with a multivitamin and mineral pill.

People with certain health conditions, or who take medications that alter their need for some vitamins or minerals, may also need to rely on supplements. And older adults, people with dark skin and those with inadequate sun exposure require extra vitamin D.

If you fall into one of the following categories, consider taking certain supplements in addition to eating plenty of nutrient-rich foods.

Women of childbearing age

Women who may become pregnant should take a multivitamin supplement that provides 0.4 to 1 milligram of folic acid, a B vitamin that reduces the risk of neural tube defects – birth defects that affect the brain and spinal cord.

Menstruating women also need 18 milligrams of iron per day, an amount that's challenging – if not impossible – to get from foods alone. Look for a multivitamin with 10 to 18 milligrams of iron. (Vegetarians need an extra 14 milligrams to account for reduced iron absorption from plant foods.)

Pregnant women

During pregnancy, women need 0.6 milligrams of folic acid from a daily supplement in addition to food sources of folate. Natural sources include spinach, lentils, asparagus, broccoli, avocados and oranges.

Pregnant women also need 27 milligrams of supplemental iron each day (vegetarian women 48 milligrams). Choose a prenatal multivitamin supplement with 0.6 to 1 milligram of folic acid and 27 milligrams of iron.

Older adults

The U.S.-based Institute of Medicine advises that people over 50 get 2.4 micrograms of vitamin B12 each day in the form found in fortified foods and supplements. That's because aging reduces ability to digest B12 from food.

Vitamin B12 helps maintain nerve function, keeps red blood cells healthy and is needed to make DNA. Evidence also suggests it may guard against heart disease and maintain cognitive function.

To get your B12, choose a multivitamin and mineral supplement. If you prefer, take a B-complex supplement that contains all eight B vitamins.

Choose a product that provides no more than 0.4 milligram of folic acid, the recommended daily intake. Recently, there's concern that higher doses may accelerate the growth of pre-cancerous cells or early cancer growths.

In healthy cells, folic acid ensures that DNA replicates normally. But cancer and pre-cancer cells synthesize new copies of DNA faster than normal cells and need folic acid to multiply.

There's no evidence that the B vitamin in foods is harmful. In fact, the evidence shows that a diet rich in natural sources of folate is good for you.

At 50, calcium requirements increase to 1,500 milligrams daily. In most cases, people need to rely on calcium supplements in addition to diet to meet daily needs.

More vitamin D

Evidence suggests that optimal vitamin-D status helps prevent certain cancers, heart attacks, multiple sclerosis, diabetes, osteoporosis and rheumatoid arthritis.

The fact that Canadians don't produce enough vitamin D in their skin from sunlight between October and March prompted the Canadian Cancer Society in June, 2007, to recommend that adults take 1,000 international units (IU ) of the vitamin daily in fall and winter.

Older adults, people with dark skin, those who don't go outdoors often, and those who wear clothing that covers most of their skin should take the supplement year-round.

Before you buy, figure out how much vitamin D you're already getting from multivitamin and calcium supplements. Choose a supplement than contains D3 instead of D2, which is less potent.

Haphazard eaters, dieters

If you don't eat well despite your best intentions, or you consume less than 1,600 calories per day, a multivitamin and mineral supplement can help make up for shortfalls. But keep in mind that supplements can't replicate the nutritional and health benefits of whole foods.

Speak to your dietitian or doctor about which supplements and what doses might be appropriate for you. If you take medications, ask about possible interactions.

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