"Health is not only the absence of disease; it is about vitality, well-being, finding joy and achieving your full potential." — Dr. Brad Jacobs
Healthy Living Tips
Calcium and Your Health
New Research Challenges Old Recommendations
Doctors and prestigious national organizations routinely recommend taking calcium supplements to support good bone health. In fact, the Centers for Disease Control reports that 60% of American women over age 60 take them. But based on recent research, experts now question whether these recommendations are a good idea. Confirming two meta-analyses published in 2010 and 2011, Dr. Kuanrong Li and colleagues recently reported an association between calcium supplementation and heart attacks. After following 24,000 Germans for 11 years, researchers found heart attacks increased by 86% among people taking supplements including calcium, and increased by 200% among people who used calcium as their only dietary supplement.
Admittedly, there were several problems with this study:
- Because only a small number of people experienced a heart attack, a small change in the number would dramatically increase or decrease the reported 'risk'.
- It did not demonstrate similar findings for stroke and cardiovascular death, which share similar intermediate pathways; thus, the strength of the association is not robust.
- Only 55% of the participants reported the names of the supplements, and only 3.6% reported 'taking calcium supplements.'
- Surveys did not ask for information on calcium dosage, type, or whether it was taken with Vitamin D, magnesium, or Vitamin K – all useful factors to provide the public with more specific recommendations.
Despite this study's limitations, the totality of research published suggests similar findings. Therefore, I have changed my perspective: I now recommend people obtain their recommended daily calcium intake from dietary sources and take supplements only on days when diet does not achieve these goals.
How much calcium is enough to prevent fractures?
The National Osteoporosis Foundation and National Academy of Science recommend:
- For women under age 50 and men under 70: 1,000 mg of calcium daily
- For women over 50 and men over 70: 1,200 mg of calcium daily
However, other research has found that 700 mg of calcium may be sufficient, and higher doses do not necessarily provide additional bone health benefits. Remember, calcium must be consumed with adequate Vitamin D in order to confer bone health protection.
What are calcium-rich foods?
Most individuals can obtain a significant portion of their daily calcium needs from calcium-rich foods like low-fat and fat-free dairy products, green vegetables such as collard greens and broccoli, and calcium-fortified foods.
How do I choose the right calcium supplement formulation?
If you do not get enough calcium from your diet, discuss with your physician whether taking calcium supplementation is right for you. Note also:
- 1. Research has not determined if different calcium supplement formulations (such as calcium carbonate, calcium citrate, coral calcium) have distinct health effects or risks.
- 2. Research has determined that:
- – Calcium carbonate requires an acidic environment in the stomach for proper absorption and is better absorbed when taken with a meal.
- – Calcium citrate is the preferred calcium supplement formulation if you are elderly, taking proton pump inhibitor or H2 blocker medication, have inflammatory bowel disease or absorption disorders, or have difficulty taking calcium supplements with a meal.
- 1. Get your calcium needs met by eating calcium-rich foods.
- 2. Limit your consumption of calcium supplements to avoid increasing your heart attack risk.
- 3. Discuss your specific daily calcium requirement with your physician: you may need less than previously thought. Although U.S. organizations currently recommend 1000-1200 mg daily, the British National Health Service, based on high quality research, recommends only 700 mg.
- 4. If your calcium intake must be supplemented to achieve your daily needs, evaluate which type of calcium is best for you.
- 5. Take at least 800 IU daily of Vitamin D3 in combination with adequate calcium intake. Have your physician check your Vitamin D blood level to ensure your level is adequate to promote strong bones and prevent fractures.
- 6. Eat dark, leafy greens for sufficient amounts of Vitamin K, which also promotes good bone health. Men need 120 mcg and women need 90 mcg daily.
- 7. Exercise for bone health. Weight-bearing exercise strengthens bones. Strength training improves balance and prevents falls that can cause fractures.
- 8. Avoid certain foods. Research suggests that excessive animal protein, coffee, cola soda, and high dose Vitamin A may weaken bones.
Q. "I have a very hectic schedule. What's the best way to unplug?"
Here are a few tips on creating a weekend that will leave you feeling refreshed:
- Turn off as many electronic communication devices as possible.
- Sleep in.
- Make a big breakfast, put your feet up and read the paper.
- Listen to music and/or dance.
- Relax amongst friends/family and laugh.
- Get a foot massage.
- Spend time in nature whether it be a walk, hike, the zoo, or playing in the park. You'd be surprised how revitalized you will feel!
- Take a walk with a friend and without your phone, blackberry or iPod.
For those of you who feel anxious at the thought of 'unplugging' for the weekend I recommend setting aside just one hour on Sunday, preferably in the early evening, to scan your email. Do your best to limit your responses to only the most critical messages. By setting aside time to check-in but not fully engage, you'll feel less anxious about Monday. You can then fall asleep Sunday evening feeling refreshed and prepared for the week ahead. For the rest of you, give yourself one hour first thing Monday morning to review emails before you get to work so you have time to prepare. Remember, three nights living 'unplugged' can make a world of difference!
Are You Getting Enough Vitamin D?
Depending on age and gender, 30 to 70 percent of Americans are deficient in vitamin D. While most people don't have any symptoms, some experience muscle pain or general muscle weakness.
Vitamin D improves muscle strength, bone health, immune function, and reduces inflammation. Scientists are just beginning to appreciate the importance of adequate levels of vitamin D. Current recommendations of 200 to 600 international units (IU) are woefully inadequate. A growing community of scientists is recommending 1,000 to 2,000 IU as a safe and necessary amount to ensure adequate blood levels for good health.
What can you do to get more vitamin D?
Sunshine is the best natural solution. In addition, supplements and dietary forms of vitamin D can help you maintain adequate levels. Fatty fish, such as salmon, mackerel, and tuna are great sources; as is cod liver oil. For example, 1 tablespoon of cod liver oil provides 1360 IU Vitamin D and 3 ounces of Salmon (cooked) provides 447 IU Vitamin D. Foods which are fortified with vitamin D have lower quantities; for example, 8 ounces of milk and 8 ounces of orange juice provide 120 IU and 137 IU of Vitamin D, respectively.
Typically, I grimace when hearing about 'cure-alls'. While not yet conclusive, vitamin D may confer health benefits for a broad range of conditions, including cancer, heart disease, depression, falls, chronic pain. Vitamin D affects immunity, inflammation, cell growth and cell death – each are critical functions across the human system. As such, it comes as no surprise that some research has shown that Vitamin D decreases cancer cell growth and promotes cell death of cancer cells. Some studies have shown vitamin D reduces breast and colon cancer risk in humans.
Given the range of health issues vitamin D may affect, I recommend the following:
1. Obtain routine annual laboratory testing to ensure serum levels of vitamin D3 are adequate (30 ng/mL minimum, and ideally > 50 ng/mL).
2. Get 15 minutes of sunshine each day and, if necessary, use food sources or dietary supplements to reach adequate blood levels.
Deciphering Food Labels
An essential aspect of good health is understanding what's in the food you eat. Excellent ways to do this are to carefully read labels of the food you buy at the grocery store and to go to restaurants that list nutritional facts and ingredients.
Top 8 Things to Look for on a Food Label:
Whether it's listed as "High Fructose Corn Syrup," "Concentrated Sugar," or any ingredient that ends in "-ose," there's sugar in what you're eating. Try to find products with less sugar or lower it yourself.
- Drinks – Did you know there is almost as much sugar in orange juice as soda? Unlike soda, you can add 1 part water to 2 parts juice, reduce the sugar by 1/3, and still have a delicious and nutritional drink!
- Desserts – When it comes to desserts, choose fruit or use a baby spoon. You'll eat just as many bites, keep the sensational flavor of the dessert, but eat fewer additional calories.
Most people get their sodium from processed foods, not from a salt shaker. Read the food label. You should aim for less than 2,500 milligrams of sodium per day, which breaks down to less than 600 milligrams for main dishes. As a general rule, avoid foods where the number of milligrams of sodium is higher than the number of calories. Read "Hold the Salt" on pilladvised.com
3. "GOOD" FATS
Polyunsaturated and monounsaturated are healthy forms of fat. Cooking with olive oil instead of butter or eating a handful of nuts are great ways to get these 'good fats'. Omega-3 fatty acids are a particularly healthy type of these 'good fats' which you can get from walnuts, soy, flax, fatty fish like salmon, as well as health bars and drinks. Try to get 1/2 gram of omega-3 fatty acids each day – and if you have heart problems, double up to 1 gram. Learn more: Read "Supplement Your Knowledge of Omega Fats" on pilladvised.com
4. "BAD" FATS
- Trans Fats Avoid trans fats whenever possible. They cause 10 times the damage to the heart as saturated fats, and have no nutritional value. Anything that says "partially hydrogenated" or "hydrogenated" on the food label means it contains trans fats, even when the package says "No trans fats". Food companies are permitted to say "No trans fats" if the food has less than 0.5 grams trans fats per serving. While that might not seem like much, most people use several servings of Coffee-mate (non-dairy coffee creamer) each day. Although manufacturers can say "No trans fats", did you know that the first ingredient in the ingredient list is 'vegetable oil containing partially hydrogenated coconut or palm kernel oil and hydrogenated palm oil'? All trans fats! If you drink 2 cups of coffee each day and put two packets (two tablespoons) in each cup, you could theoretically find yourself drinking up to two grams of trans fats every day.
- Saturated Fats Primary sources of these fats are from animal products such as meat and dairy. As a general rule, you want to eat less than 10% of your calories from saturated fats – this equals about 27 grams of saturated fat in a 2100 calorie diet. For example, a 10 oz prime rib has 45grams, a 20 oz filet mignon has 22grams, 9 oz chicken breasts has 6 grams, and 7 oz grilled salmon has 2g
Look for products that have fiber, in general more is better. Aim to get at least 20 grams of fiber a day. Read "A Tale of Two Fibers" on pilladvised.com
Products list wheat products in many ways (enriched, unbleached, wheat, etc.). However, unless it says "whole wheat", the grain in the product is a white grain and is not as good for you as whole grain.
7. SERVING SIZE
Often your idea of a serving size isn't the same as the manufacturer's. For example, if you drink 12 ounces of juice every morning, but the serving size is 8 ounces, then every number on the label needs to be adjusted accordingly –thus, multiplied by 1.5.
Depending on whether you are trying to maintain your weight, lose or gain weight, keep an eye on the number of calories you eat – and keep a running tally on the calories you consume in a day. Your daily calorie needs should dictate how many calories you take in over the course of a day.
Bitters & Carminatives for Indigestion
As we age, many people have indigestion or feel bloated after meals. Thankfully most traditional cultures offer effective remedies. You may recall your grandparents bitter-tasting appetizers or drinks 20-30 minutes before their meal. These "bitters" prime the gastrointestinal tract for the upcoming meal by stimulating gastric acids and pancreatic enzymes that digest food and aid digestion. Examples of bitters include dandelion, gentian, yarrow, artichoke, and orange peel. A wonderful and effective herbal bitter formula that helps with digestion before meals is Flora Gallexier Herbal Bitters.
Other remedies to consider are carminatives, which include culinary spices like cinnamon, caraway, peppermint, fennel, and dill. These herbal spices relax smooth muscles, thereby reducing bloating, cramping, and gas pain that people may experience after eating large meals. In many cultures, carminatives are often ingested as an 'after-dinner drink' in the form of 'digestifs'. Examples include cr�me de menthe and Campari, which contains 50-80 undisclosed ingredients. For those who prefer a less intense, non-alcoholic beverage after dinner, you might consider peppermint or mint tea, or the East Indian tradition of chewing on fennel seeds (with or without candy coating).
Finally, there are many dietary supplement formulations designed to reduce indigestion and bloating. I have had great success recommending enteric-coated preparations that contain peppermint oil combined with caraway seed oil.
What are the health benefits of Green Tea?
At the 6th Annual International Conference on Frontiers in Cancer Prevention Research, Rutgers investigators announced that rats fed a diet equivalent to 4–6 cups of Green Tea, in humans, were 55% less likely to develop colon cancer and among those that did, the tumors were 45% smaller compared to the control group. Researchers have published conflicting research on the specific health benefits of green tea; however, the number of studies showing promise is impressive across a number of conditions, including:
- prostate cancer
- breast cancer
- pancreatic cancer
- heart disease
The exact mechanism of potential benefit remains unclear. Given that green tea is safe and likely has a range of health benefits, the next time you are considering grabbing something to drink... consider green tea!
Your Attitude Can Affect Your Health
Research suggests that your attitude can actually influence your health – and it's not just your emotional well-being that is at stake. A study among 3000 British adults found attitude affects stress hormones and inflammatory markers. An earlier study found pessimistic men have twice the risk of developing heart disease; another study showed pessimists recovered more slowly after heart bypass surgery than their optimistic counterparts. In a long-term study among people with HIV, people who had a more positive attitude lived longer than those who did not.
Good News: Beyond our genes, our attitude is influenced by our patterns of thinking, social relationships and life fulfillment. That is why programs like Mindfulness-Based Stress Reduction and Reflective Happiness have been so successful for participants. Not only do people begin to view the world with a "cup half-full" attitude, but research using MRI brain scans find more activity in areas of the brain associated with an optimistic worldview, thus providing objective evidence to support the survey findings.
Take Action: Enroll in one of these programs or join one of my 3-Day Health Retreats. Together we can learn to reframe our perspective, manage stress better, and focus on things that make us feel good and truly satisfied.
Good Oral Health
Is there a relationship between good oral health and good health overall? Have you heard about a lollipop and chewing gum that fight cavities?
The health of your oral cavity – mouth, teeth and gums – plays an important role in your overall health. For example, studies have shown a correlation between dental health and heart attacks. One proposed explanation is that poor dental hygiene causes chronic inflammation, which in turn has harmful effects on the entire body. In addition to brushing your teeth twice a day and regular flossing, what else can you do to maintain good dental health for your and your family? Here are two additional suggestions:
- Dr. Wenyuan Shi at the UCLA School of Dentistry developed a sugar-free herbal lollipop called Kavidy Kops. The orange-flavored lollipop contains an all-natural extract from the root of the licorice plant (Glycyrrhiza uralensis) that has been shown to kill cavity-causing bacteria called Streptococcus mutans in the laboratory. Diabetic friendly and gluten free, the lollipop helps maintain healthy teeth and fight cavities, which affect people of all ages. Just think, this lollipop could improve your dental health and by doing so, help prevent heart attacks!
- In addition, research has shown that chewing gum containing xylitol is an effective strategy for fighting tooth decay. Xylitol, a sweetener used as a naturally occurring sugar substitute, reduces acidity and Streptococcus mutans in the mouth, whereas gum containing sorbitol, for example, increases acidity and promotes tooth decay.
Taming Seasonal Allergies
It seems like everyone I know is suffering from seasonal allergies, also called hay fever. Roughly 40 million people suffer each year from seasonal allergies – and suffer they do. Runny nose, itchy and watery eyes, sneezing, head congestion and fatigue are just a few of the seasonal allergy symptoms that people experience.
There are some great allergy survival tips worth considering. To reduce the allergen count in your home and your body, I am a big fan of keeping a clean home including a HEPA filter, and using a netti pot to wash out the nasal passages. Butterbur has been getting a lot of press lately; Dr. Guo published a review showing that the Butterbur herb was better than placebo, or as good as non-sedating antihistamines, in 6 randomized trials. You also might try a homeopathic preparation called Galphimia glauca, and keep an eye out for a new Chinese herbal formula called Biminne which looks promising.
Wishing you an active and hay fever-free spring season!
Integrative Medicine & Alternative Medicine
Q. "What is the difference between Integrative Medicine and Alternative Medicine?"
Alternative Medicine is a term used to describe over 100 healing therapies not traditionally taught in medical school. Integrative Medicine, on the other hand, is a rapidly expanding field with the primary mission to restore the soul of medicine.
Whether you are pregnant, scheduled for heart surgery, experiencing depression, or have diabetes, Integrative Medicine couples the best of conventional scientific medicine with a broader perspective on the nature of illness, healing, and well-being.
When receiving Integrative care, you will experience a provider who is focused on healing the whole person and actively encourages you to participate in improving your health. In addition to training in conventional scientific medicine, they are open-minded and knowledgeable about:
- Alternative therapies or health systems such as Ayurveda, Chinese medicine, acupuncture, chiropractics, yoga, massage, meditation or other mind-body practices
- Appropriate use of dietary supplements including herbs and vitamins
- Healthy aging practices such as fitness, movement therapy, stress management practices, healthy eating and smoking cessation
- Activating the body's innate healing response
- The healing potential of meaningful patient-provider relationships
- The importance of empowering patients and helping them navigate through the maze of therapies available today
- Serving as role models and guides to their patients
With the holidays coming, there's one thing you can count on – eating so much festive food that your stomach aches. Did you know the average American consumes 3,000 calories during Thanksgiving dinner alone? So it's no surprise that many people experience indigestion and/or heartburn.
Make your holiday guests (and their tummies) more comfortable – plan ahead and have some simple home remedies on hand. They'll feel better and you'll get bonus points for being a terrific Thanksgiving host! Here are a few suggestions:
- Serve dinner in courses. It takes the stomach 20-30 minutes to signal the brain that it's had enough food. This will help avoid over-eating.
- Take a 20-minute stroll after your meal to help with digestion.
- Serve peppermint tea after a meal. It reduces cramping and discomfort by relaxing smooth muscles that line the intestine.
- For those with stomach indigestion and bloating, try STW 5 herbal formula. This remedy contains a mix of herbs that include bitter candy tuft, matricaria flower, peppermint leaves, caraway, licorice root and lemon balm.
- Try Artichoke leaf extract. Take 320 mg of a standardized artichoke extract three times daily.
If anxiety is disrupting your sleep, you'd be surprised how effective relaxation techniques can be. I suggest doing one of the following techniques for 10-30 minutes daily or whenever you are feeling particularly anxious:
- Guided Imagery
- Breathing exercises
- If you have problems sleeping after eating a large meal, consider taking herbal remedies such as Valerian, milky oats, and/or Hops one hour before bedtime.
Bradly Jacobs, MD, MPH – Cavallo Point Healing Arts Center & Spa
601 Murray Circle | Fort Baker | Sausalito, CA 94965
Phone: 415.339.2692 | Email: email@example.com