Calcium and Vitamin D are still important!

The Institute of Medicine Report was published yesterday and I watched the national news outlets do the report a disservice--those darn sound bites just can't capture the complexity of the report. (The complete report can be found on the IOM website http://www.iom.edu/).

The report concluded that there is not enough evidence to increase the recommended intakes for vitamin D or calcium but that is far from saying that we don't need these 2 critical nutrients for bone health. Most people don't get the recommended amounts of these nutrients in their diets but that message was lost in the reporting. I would not want women of any age to abandon their efforts to get calcium from their diet or supplements. I always recommend food first and there are more foods with added calcium--from orange juice to breakfast cereals--available in the grocery store. A recent study looked at calcium intake in post menopausal women and found that dairy foods were the number one source of calcium for white women but grains contribued the most calcium to the diets of black women.

Older women who don't get enough calcium should use calcium citrate supplements--they are better absorbed than calcium carbonate supplements as we age. But, more isn't better and I think that is what the report was trying to stress.

The more controversial part of the report was on Vitamin D; this nutrient is also crucial for bone health--nobody disagrees with that--but there are also claims that this sunshine vitamin also plays a role in diabetes, heart disease, auto-immune diseases and some cancers. It is not surprising to me that the report did not find a strong link with Vitamin D and other disorders because the research is emerging and no conclusions can be reached. Science moves slowly but the media reports every little study as if a cure for every disease was as simple as popping a supplement. The hype is often well ahead of the science.

So, don't throw away your supplements--make sure to get adequate, not excessive, calcium and vitamin D in your diet and then add what is missing from supplements. Remember that supplements are meant to supplement diet--not replace it.

Food Trends Recognizing Aging

I was excited to see that one of Mintel's 2011 "megatrends" is recognition of the demographic shifts and the aging workforce.

http://www.foodnavigator.com/Financial-Industry/Demographic-shifts-to-determine-food-trends-in-2011-Mintel

Today's food products are geared toward the youth (think energy drinks) but Mintel predicts that more products will be targeting "vitality and health" for those of us who are older. And why not, given that the number of us in the U.S. aged 45 to 64 who will reach 65 over the next 20 years has increased by 31% in the last decade. Baby boomers are more likely to be active, too. The Health Club industry says adults age 55+ comprise a quarter of health club memberships. From 1998 to 2005 those over 55 joined gyms--33% increase from earlier years while the 18 to 34 year old age group showed no increase.

Here is my wish list of products that I would like to see the food industry develop and market to older adults:

• Half loaf of whole wheat bread (I can never finish a whole loaf of bread and bread just doesn't freeze well)


• Sports drinks with lower carbs (4% range) without being sickly sweet with fake sugars (older adults were diluting sports drinks long before sports drink makers came up with "light" versions but those are still too sweet tasting. This reminds me of Dr. Randy Eichner, retired team doc for the University of Oklahoma Sooners, who encouraged Gatorade to make a drink for older adults and call it "Later Gator.")


• Lower sodium everything products while at the same time increasing potassium; both nutrients are important for managing blood pressure.


• Yogurt with more calcium and vitamin D. At a recent food conference I tasted Yoplait yogurt that is being introduced soon and it will have 50% of the daily value for calcium and vitamin D--great job. Most people are surprised to learn that only a a couple of yogurt brands have any vitamin D. And Greek yogurt (which I love) has more protein than regular yogurt, but less calcium and no vitamin D.

We might be "older, lower, and slower" (a slogan used by some master athletes who pole vault at senior games) but we have the financial means to purchase food products that help us stay vital and healthy.

Joys of Pomegranates

Until this weekend I had only enjoyed pomegranates in a pomegranate martini. That changed when my sister brought me a bag full of pomegranates from our neighbor's pomegranate tree. I didn't even know that this fruit grew in Georgia! I dug out The Essential Eating Well Cookbook (350 recipes from that great magazine, EatingWell) to figure out what to do with, what the Food Lover's Companion calls "nature's most labor-intensive fruit."

The fruits were ripe and laden with ruby red seeds and juice. It took a lot of work to get some juice (6 pomegranates are needed for 1 cup of juice) and I barely got a cup of juice, but did harvest hundreds of seeds (a testament to the part of the name "grenate" for many-seeded.)

Pomegranates are loaded in antioxidants--those helpful compounds that fight diseases like cancer and heart disease. The longer we live the more damage from oxidation can occur in the body (like rust on on old car) so eating foods rich in antioxidants is a smart move for those of us who have a few miles on our bodies. Antioxidant supplements have not proven to be as effective in fighting disease as researchers had hoped, but eating foods rich in antioxidants has many benefits. These foods tend to have the whole package for good health: low in calories, low in saturated fat, high in fiber, vitamins and mineral, and loaded with antioxidants. Pomegranates are also high in potassium, a mineral that can help lower blood pressure.

I made 2 dishes with my pomegranates--a chicken tagine (a Moroccan-inspired recipe from the Eating Well cookbook) and a dessert with apples and pomegranate seeds. The chicken dish used both pomegranate juice (which I had to supplement by using POM Wonderful juice) and seeds for crunch and a tart flavor burst. Both were yummy and I saw no empty plates from my dinner guests.

This special fruit is only available October through December, so try it for yourself and enjoy the taste and nutrition of pomegranates this fall.

Cancer Survivors and Lifestyle Changes

October is Breast Cancer Awareness month and I just reached survivor status this month by being cancer-free for 5 years. The American Cancer Society estimates that there are 11 million cancer survivors and by the year 2020 there will be 20 million of us.

Every cancer survivor celebrates beating cancer but also worries about it coming back. The good news is that simple lifestyle changes can stack the odds in your favor. Try these 5 things to help fight your cancer from coming back.

1) Be active every day. Exercise can help control your weight and excess weight increases levels of estrogen and insulin--two hormones that fuel cancer cells. Exercise also fights other chronic diseases like diabetes, high blood pressure, and osteoporosis.

2) Eat and least 5 servings of fruit and vegetables every day. It is easier than it sounds because a small glass of juice, blueberries on your breakfast cereals, a veggie-packed salad at lunch, and an apple gives you the 5 servings needed for good health. One on my favorite quick dinner meals is a saute of veggies (green and red peppers, broccoli, asparagus, and onions) with olive oil and tossed with spaghetti noodles and sprinkled with fresh grated Parmesan cheese. Yummy and a 2 to 3 serving of vegetables meal.

3) Decrease or eliminate processed meats--no more bologna (I grew up on bologna and fried bologna sandwiches were a staple in my family), bacon, sausage or processed luncheon meats.

4) Get more the of the sunshine vitamin--vitamin D. This nutrient is showing promise as a cancer fighting vitamin. Ask your doctor to check your vitamin D level to get a baseline before you start supplementing with vitamin D pills. But eat vitamin-D rich foods every day such as fatty fish and dairy foods fortified with vitamin D. Yogurt is a popular dairy food for its calcium and protein but did you know that not all yogurt has vitamin D? Turn the carton over and look for vitamin D and don't be surprised if you find zero vitamin D in your yogurt. The exception? Yoplait yogurt has 20% of the daily value of vitamin D in a serving so kudos to Yoplait. And, Yoplait also is a big supporter of breast cancer research--their save the lids campaign benefits Susan G. Koman for the Cure and so far they raised over $1.6 million from this year's campaign. So dig your spoon into that!

Cut the salt

I've heard it before, "I don't use the salt shaker so I don't have to worry about salt intake." Wrong. Seventy-five percent of the salt in our diets comes from the salt added by food processors so even if you don't touch the salt shaker you are getting more salt than you realize.

The 2010 Dietary Guidelines for Americans recommends reducing sodium intake (salt is 40% sodium and the rest is the mineral chloride) to 1,500 milligrams a day. That is equal to 2/3 teaspoon of salt. Cutting sodium intake to 1,500 milligrams a day is a herculean task for most of us--especially if you eat out. Consider that 2 slices of Pizza Hut Supreme pizza has 1,780 milligrams of sodium and Olive Garden's Shrimp Caprese has 3,490 milligrams of sodium--so you can see why it is so difficult to get to the recommended 1,500 milligrams per day.

Many food companies are jumping on the lower sodium recommendations and that is good news for all of us. One of my favorite pantry items is canned beans--kidney beans, black beans, and garbanzo beans all make an appearance in my meals. The bean has everything--protein (much more than other veggies), fiber, vitamins and minerals. Up until now, canned beans also had a lot of sodium, but now there are two solutions for reducing sodium in canned beans. One is using the line of Bush's lower sodium beans. They've cut the sodium in half in canned beans. The second is the drain and rinse technique. Researchers put this method to the test and found that draining canned beans reduces sodium by 36% but draining and rinsing can reduce sodium by 41%.

So next time you reach for a versatile can of beans, drain the beans in a colander for 2 minutes, rinse under tap water for 10 seconds, and let the beans drain for 2 minutes for easy an sodium reduction to get you on your way to 1,500 milligrams of sodium each day.

Healthy Aging

Healthy aging isn't an oxymoron. You can be healthier and more fit at 60 than you were at 40 if you exercise--both aerobic exercise (brisk walking, jogging cycling, etc) and weight training or resistance exercise. While most of us know that aerobic exercise is important for good health, as we age strengthening our muscles may be even more important for good health. It is especially important for functional health--that is, being able to perform the everyday activities that we did when we were young without even thinking about them. Things like lifting and carrying a 50-pound bag of dog food or reaching the top shelf in the kitchen cabinet or maintaining our balance without worrying about falling. We lose muscle mass as we age, something researchers call sarcopenia, but it can be prevented with strength training and diet.

You don't have to go to a gym to strength train, although that is a good option. Using resistance bands or hand weights can have the same effect as fancy gym equipment--the key is to do it two or three times a week and eat a diet with good quality protein to promote muscle strength. The two go hand-in-hand. I always tell athletes that you can't push protein into muscle to make it bigger--you have to pull it in with strength training.

What is a good diet for muscle? Research suggests getting high quality protein three times a day. Aim for 20 grams of protein at breakfast, lunch and dinner. Spreading the protein throughout the day is better than eating it all at one meal. What is high quality protein? Protein from meat, fish, dairy foods, eggs, or soy is all high quality. Twenty grams of protein is found in a little over 2 cups of milk or yogurt, and 3 ounces of meat, fish, or poultry and 3 eggs. Nuts are also a good source of protein and make for a good protein-rich snack.

I recently retired after 30 years of teaching and one of my colleagues said we spend the first 30 years of life getting our education, the second 30 years making a living, and if we are lucky the next 30 years enjoying life and doing what we love. Here's to the next 30 years--now I'll have time to get fitter and pick up those weights.

Forty ng/mL? That is the level of vitamin D (also called serum 25(OH)D3) in my blood but what does it mean? Vitamin D is one of the most talked about nutrients and for good reason--along with calcium it is critical for building and maintaining healthy bones, but vitamin D is also one of the most confusing vitamins. We can get vitamin D three different ways:

• through foods (although very few foods are good, natural sources)
• through supplements (although it comes in different forms and researchers aren't always consistent in their advice about which form is best)
• through sunshine or the ultraviolet rays from the sun to be more precise (but SPF 8 or greater, heavy cloud cover, skin color, aging, and even the angle of the sun in winter blocks vitamin D from being made in sufficient amounts)

So what is an over-50 year old adult to do?

First, choose foods that contain vitamin D or foods that are fortified with vitamin D: salmon, mackerel, tuna and sardines are good sources because fatty fish contain this fat-soluble vitamin. Mushrooms (they are being exposed to ultraviolet light to make them good sources), milk, some but not all yogurts (read the label), many breakfast cereals and orange juice contain vitamin D. A recent study found that half of vitamin D intake comes from milk so that is a good place to start.

Second, consider supplementation; you might be getting some in your multi-vitamin and most contain 400 IU (IU stands for international units, the measure used in supplements). Vitamin D comes in two forms--D2 and D3 and most, but not all, experts recommend the D3 form because early research showed that D3 is more effective at raising vitamin D blood levels than D2. However, some research shows that both forms are effective at improving blood levels.

Third, consider getting some sensible sun--10 to 15 minutes of sun exposure twice a week can improve vitamin D levels. This recommendations is controversial because UV rays from the sun or tanning beds are tied to the million of skin cancer diagnoses each year.

Which leads us back to that 40 ng/mL blood level--is that good or bad? According to the lab report 40 is a healthy level, but trending more toward the insufficient end of the range. A controversial article in an international osteoporosis journal suggests that older adults need 800 to 1000 IU of vitamin D each day to reach the maximal blood levels of vitamin D.

Next time you go to the doctor and have blood drawn, ask for a vitamin D level--in the meantime, increase your intake of vitamin D from foods and if you supplement, look at the supplement label to determine how much vitamin D your supplement provides.

For more information check out Dr. Michael Holick's website http://www.vitamindhealth.org/ or his new book, The Vitamin D Solution.

Nutrients for healing

After the recent blast of cold air that blanketed the country, including the deep south, I had planned to write about comfort foods and share my favorite soup recipes, but then I fractured my wrist and have been focusing on healing nutrition. Working with athletes for many years has given me a glimpse into the healing process, but I never had to experience it for myself.

Healthy bone needs more than calcium--it takes 17 different nutrients to make a strong bone. Let's start with protein--a key building block of bone. Protein is needed for growth and repair so I am focusing on high quality protein that provides all of the essential amino acids--low-fat milk, yogurt, eggs, lean meat, and low-fat cheese. Soy protein is another complete source of protein, and beans, while not providing all 22 of the essential amino acids, has the highest protein content of vegetables.

Zinc and copper help heal bone by building collagen--the protein matrix for wound healing. Seafood, sunflower seeds, nuts, mushrooms, and wheat germ are all good souces of these trace minerals.

Two vitamins that are frequently overlooked in the healing process are vitamins A and C--vitamin A promotes bone growth and remodeling and vitamin C is also needed for collagen formation and bone repair. Citrus foods and dark red and green veggies and fruits provide both vitamins.

OK, we do have to recognize the superstar, calcium, since 99% of calcium is found in bone. I like low-fat dairy because not only does it give me needed calcium, but also vitamin D, protein, and vitamin A. Drink calcium-fortified orange juice for both calcium and vitamin C. A multi-vitamin mineral supplement doesn't give you enough calcium, so take calcium carbonate or citrate every day. I prefer calcium citrate as it is well absorbed without food. The recent 2009 position paper from the American Dietetic Association recommends taking no more than 500 milligrams of calcium at one time, so split your dose.

My perfect bone healing meal? Lean beef fajitas with red and green peppers, mushrooms. and a side of black beans and citrus fruit salad. A big glass of cold low-fat milk--the margarita will have to wait until after the bone heals. Alcohol is not good for bones. Now, if only I could find a nutrient that would help me type faster with my left hand.....

Fit to Eat by Chris Rosenbloom, PhD, RD

Happy New Year! For five years I wrote a weekly column for the Atlanta Journal-Constitution titled "Fit to Eat." As newspapers continue to shrink in size, scope, and importance, I will carry my column forward in this blog. As a nutrition professor and registered dietitian, I will write about food, nutrition, and fitness and hope my newspaper readers will find interest in my writing.

Now that it is 2010, here are my suggestions for the top 5 new year's resolutions that you should not make.

• Lose weight. This may be one of the most popular new year's resolutions but it is also the easiest to break. This year aim for health, not weight loss. You might be surprised that by eating healthfully and making small changes to your activity patterns you might drop some pounds without even trying.


• Join a gym in January. It is depressing to go the gym in January--the place is crowded, you have to wait for a treadmill, and the lines for the weight training machines are nuts. Wait until February when the crowds thin and the new year's resolutions have faded.


• Drink 8 glasses of water a day. Stop carrying around that gallon jug of water; there is nothing magical about drinking 8 glasses of water. All beverages count toward hydration--even caffeine-containing drinks, so stop counting water glasses.


• Eat out less. Nothing wrong with eating out if you make the right choices. Start your meal with a broth-based soup and split an appetizer, salad, or entree to save money and calories.


• Stop comparing your body to the models on the pages of health and fitness magazines--they are bad for your mental health. Every photo has been altered to show an image that is unattainable. Check out the DVD, "America the Beautiful" to get an insider's look to our obession with beauty. This year learn to love your self.