Archive for September, 2016

Help for making and preserving lean tissue

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Two weeks ago we covered the importance of muscle mass. Last week I discussed protein as a key requirement for building and maintaining muscle. Obviously, using muscles as in strength training is also necessary. I’ve included the drawing of “core muscles.” You probably know that we should work especially diligently on strengthening them to help balance among other benefits. (Some basic exercises like squats and planks help a lot as do programs like yoga and Tai Chi.) This week I want to briefly review what supplements help; what hurts muscles and what to do about cramps.

Supplements

Many aspects of health affect our ability to maintain our strength. So, it is likely that we could make a case for a great many supplements. Here is just a sample:

  • Probiotics. It has been shown that the elderly become more frail when their intestinal microbes become depleted and imbalanced. That often happens due to the diet and other factors common to institutional housing (e.g. rest homes). There is increasing interest in doing studies to show how probiotics may help this frailty which is mainly loss of muscle mass (sarcopenia). In one animal study a bacterial strain (Lactobacillus plantarum TWK10) was found to help build muscle. It is likely that other strains do that as well. For one thing, probiotics help us absorb and use the nutrients required to make muscle. After all the study I did while writing The Probiotic Cure, I still could not find a product that compares to Ohhira’s Probiotics.
  • Vitamin D. Most studies on vitamin D and muscles do show benefit, but have used it in combination with other factors such as diet. This linked study of frailty in the elderly, indicates that vitamin D helps. But, as always, the scientists say that more research is needed. Given the dozens of other benefits of vitamin D, I wouldn’t wait to get my blood levels into an optimum range. (I have written about vitamin D in the Library and we will talk about it on the show later in the month.)
  • Creatine. The body makes creatine (technically a nitrogenous organic acid) and uses it to help give cells energy to do their work. Because we don’t necessarily make enough, it has been studied as a muscle supporting supplement for many years. In this particular study of older adults, creatine was found to be more effective for men than women.

What isn’t a help

  • Androstenedione (an anabolic steroid precursor) has been touted in the past by body building magazines. But, it appears to be ineffective and potentially dangerous. It is hard now to find it in a supplement. (By the way, a British study found that the advice in men’s fitness magazines is generally unreliable.)

What keeps muscles from repairing / building?

  • Age and inactivity
  • Overeating of calories, sugar, inflammatory fats (e.g. omega-6 from vegetables oils) and even excess protein (see last week’s blog for normal ranges).
  • General toxicity

What actually damages muscles?

  • One class of antibiotics (Fluoroquinolones, or quinolone)
  • Some statin cholesterol-lowering drugs have muscle damage as a potential side effect.
  • Free radicals or oxidants damage all tissues including muscles. Protection against free radicals is why we eat antioxidant foods and take antioxidant supplements. Glutathione is the master antioxidant. In one study it was shown that low glutathione caused DNA damage and increased molecules that tell muscle cells to die. Glutathione is expensive and not very effective taken as a pill. However, there is a beneficial bacterial strain ME3 that becomes a little glutathione generator in our gut.

Muscle cramps?

Cramps are painful episodes where muscles get stuck in contraction mode and can wake us up ready to scream. Of course, strenuous activity is a factor in causing them and stretching afterwards helps. There are other factors and remedies:

  • Water. Cramps seem more common when we haven’t had enough water before, during and after activity.
  • Magnesium. Without calcium a muscle cannot contract. But, without magnesium it cannot relax. (I recommend magnesium for monthly cramps too.) When we work or exercise outdoors we worry about keeping electrolytes. Electrolyte sports drinks contain sodium and potassium which does help prevent cramps. Unfortunately, many (if not most) do not add the electrolyte magnesium. Since we need magnesium for so many other purposes, it is likely important to supplement it daily.
  • Home remedies. The People’s Pharmacy newspaper column and website often discuss how to reverse a cramp. Among the most consistently applauded is eating a spoon full (or take-out packet) of yellow mustard or drinking a little pickle juice. The most curious remedy that many swear by is putting a bar of soap (e.g. ivory) under the sheet to keep leg cramps at bay.
  • Homeopathic help. King’s Cramp & Spasm Relief would be handy to have on the night stand because you wouldn’t need to even turn on a light. Just grab it and swallow 3 sprays from the pump.
  • Something to avoid. If you drink Earl Grey tea and also have muscle cramps, there may be a connection. The bergamot used in its flavoring is the suspect.

 

Do you eat enough protein?

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In last week’s blog we talked about the importance of maintaining muscle mass even into advanced age. One requirement for building and maintaining muscle is adequate intake of protein.

Experts do not all agree on the amount of protein we require, but they do generally agree that the goal should vary by person. As you can see from this Kashi calculator, if you enter a weight of 155 pounds and check that you are moderately active, it doesn’t give one number…it gives a range—56 to 106 grams. That is a huge spread. It likely reflects a bunch of individual differences such as proportion of existing muscle mass; whether or not a person is taking acid-blocking drugs (among other insults, those drugs keep us from properly digesting protein); and even what kind of bacteria live in a person’s intestinal track.

Kashi is obviously promoting their own products and they are probably better than most. However, I think un-fermented grains in products like cereal should not be a large part of our diet and they may actually be a problem for many people. None the less, this calculator could be very useful in getting an idea how much protein we eat.*  You can see, for example, that while it has a reputation for being a “protein food”, 1 tablespoon of peanut butter only provides 4.6 grams of protein. A slice of the highest quality whole grain bread might add another 5 grams. (Other brands might list higher protein numbers, but that is often because their bread contains more gluten. Gluten will have to be another blog.) A tablespoon of grape jelly adds zero protein. Depending on the brands selected, this PBJ toast may contain a lot of sugar, some trans fats and other undesirable ingredients. (There is no substitute for reading not only the nutrition facts on the label, but also the ingredient list.)

Studies show that a large percentage of the population, especially seniors, do not do not get enough protein. In contrast to the PBJ above at 9.6 grams, a single egg has 6.2 grams of protein. Therefore, 2 scrambled eggs start the day with 12.2 grams. Even at the low end of that 56/106-gram range, you can see that there is a long way to go. More examples: One half a cup of cottage cheese contains 14 grams. A 6-ounce salmon steak delivers 33.6 grams! You will notice that the calculator doesn’t list fruit because it has so little protein. The vegetables they list are beans and peas because green leafy veggies have very little protein. A shortcut to adding protein is adding a protein powder such as the one Dr. Young has made.

You might already be getting the idea that vegetarians have their work cut out for them.  Whether or not it has to do with blood type as some have suggested, I think some folks are just genetically better prepared to be vegetarians than others. They may also have an assortment of intestinal bacteria better suited to extracting the protein from plants. I have tried several times to be a vegetarian, but became weak and tired.

There are various eating patterns labeled “vegetarian”. The strictest definition and most nutritionally challenging is “vegan”. In that diet one gives up anything that ever had anything to do with an animal—perhaps even leather shoes. Vegans need to really work at getting adequate protein and other nutrients such as vitamin B12, iron and zinc.

“Lacto-ovo vegetarians” eat eggs and dairy. “Pescatarians” add fish to their diets. (Smaller wild fish are the least contaminated.) I’ve heard people who eat eggs, dairy, fish, as well as some chicken and occasionally other meats describe themselves “vegetarian”. Perhaps those folks are just not clear on the concept. We could more properly call them “flexitarian”. That plan is the easiest to manage and is what I recommend for most people. In short, get lots of vegetables, fruits; eat eggs; and a moderate amount of animal-source protein. Pay careful attention to the source and quality each food. E.g. there are several reasons that red meat raised on grass without antibiotics and hormones is better (LINK) and if you eat grains get them whole.

Author Lierre Keith was a very strident vegetarian until she found that she could not get well on that diet. She began investigating all the long-held nutritional, environmental, political and humanitarian justifications for vegetarianism and wrote the very interesting book The Vegetarian Myth: Food, Justice, and Sustainability. It calls a lot of those common beliefs into question. (Interviews I had with her: April 2010 and May 2010.) In a more recent interview, guest Judith D. Schwartz opened my eyes to the important role farming methods have on greenhouse gases and climate change. Her book is Cows Save the Planet: And Other Improbable Ways of Restoring Soil to Heal the Earth.

* Tip: Walmart’s website lists the nutrition facts on brand name foods that they carry. So, you can do research no matter where you shop. For complete nutrition information on virtually any food, the USDA database is a great source.

 

Muscles do more than lift weight and impress your friends

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Sure, muscles can help you lift a gallon jug of milk and look good in a tank top. But, muscles do a lot more than that and it is easy to forget about them. You might be surprised just how critical muscle tissue is to overall health. For example:

  • We know that exercise benefits the brain and exercise requires muscles.
  • Muscles help us to be mobile so we can better enjoy life and maintain social networks.
  • Muscles maintain our posture and therefore reduce the risk of skeletal problems and the pain those can bring. (Our chiropractor can put bones back where they belong, but our muscles have to keep them there.)
  • Core muscle strength helps hold our organs in place.
  • A strong core helps maintain balance and avoids falls.
  • Muscles burn fat and help maintain healthy blood sugar.

Wasting away of muscle mass is a gateway to disease and is a typical (but not necessary) sign of aging. Those over age 60 with strong muscles have a 50% lower risk of an untimely death! The medical photos of muscles of a 74-year-old triathlete look just like those of a 40-year-old triathlete. (However, the muscles of a sedentary 74-year-old are not a pretty sight.)

It sure looks like we should pay attention to whether we are building muscles or tearing them down. Increasing muscle mass requires eating adequate high quality protein and a variety of nutrients. Of course, it also requires doing the kind of exercise that uses muscles. (Oops, strong thumb muscles from texting or hitting play on the remote do not count.)

Next week we will begin looking at what the science says about supplements for muscle building; what boosts muscle function and stamina; factors that interfere with muscle building; and what to do about muscle cramps.

Vitamin D dose confusion sorted out

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There is vitamin D dose confusion. There is NOT confusion about the importance of this hormone-like “vitamin”. Apparently it is important for just about every aspect of our health. For example, the following quote is taken from my Library article on D: “inadequate Vitamin D levels are associated with arthritis, asthma, infections, depression, diabetes and dementia. Researchers also seem to agree that vitamin D helps prevent several cancers, heart disease, autoimmune conditions (e.g. multiple sclerosis), influenza, complications of the flu and in fact, death from all causes.

It seems likely that in children, deficiency of Vitamin D may well be ‘THE [that emphasis was in the original quote] leading cause of cancer, type 1 diabetes, asthma, allergies, atopy [e.g. eczema], and possibly epidemic autism.’1 The elderly should note that Vitamin D increases muscle strength and brain function while reducing chronic pain.”

You are not average. (I don’t mean that in the same sense that some parents constantly tell their children that they are exceptional at, let’s say, playing the violin, when there is ample evidence to the contrary.) I mean that your biochemistry is like no other person’s. Vitamin D provides a good example of why official pronouncements and guidelines can sometimes be nearly useless. That is because they speak to a theoretical “average person”. Below are examples that illustrate my point. They are abstracted from a blog by my friend, an expert on bone health, Dr. Susan Brown.

  • One woman in Connecticut had to increase her intake to 8,600 IU for several months to reach the ideal [per Dr. Brown]* blood level of 50 ng/mL.
  • A Denver client had a blood level of 53 ng/mL vitamin D in January when she was only taking 1,000 IU daily.
  • And then there’s Dr. Brown’s experience in central New York. “I was using 2,800 units of vitamin D during the summer and getting lots of sunshine from my outdoor activities, but I still tested at 35 ng/mL in October.  If I had not raised my wintertime vitamin D intake substantially to 5,800 IU/day, I would’ve had a very inadequate level of vitamin D during the winter.”

Until you know how your body reacts, it looks like it might be smart to test your vitamin D blood levels both in the summer and in the winter. If a person isn’t able to be tested, many experts believe that 7,000 IU per day is reasonable to supplement. (I think it is much scarier to be too low than too high.)

*Don’t worry if blood tests show higher than 50. Some experts think ideal is 75+ and there is no real concern up to 100. Click here to read my article for more information and  resources on vitamin D.

1J. Pizzorno. “Vitamin D: Still Learning About Dosi

Supplement benefits are backed by good science

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Hopefully, very few people take it seriously when some of the so-called “experts” imply that dietary supplements are just a frivolous fad based on old wives’ tales. Let me address that last part first. Grandma was an “old wife” and most of what she told us about health holds up under scientific scrutiny. And are they a fad? No, I don’t think so. According to a Gallup survey, cited in the current Consumer Reports magazine, 94 percent of physicians now recommend vitamins or minerals to some of their patients and 45 percent have recommended herbal supplements. Supplement benefits are backed by good science.

Benefits: Supplements could save untold suffering and billions of dollars in disease care costs. Any bottle could be quite an impressive gift of health for the right person at the right time. You certainly don’t need to take my word for it. Just take a peek at government-run websites like www.clinicaltrials.gov and https://www.ncbi.nlm.nih.gov/pubmed/ that show tens of thousands of research studies with positive results on supplements. Those benefits cover virtually any complaint we could have. However, except for just filling in nutrition basics, we may need a nutritionist’s help to figure out what supplements to take because the labels are not legally allowed to say much. (E.g. like the generically gift-wrapped bottles in the photo above.)

Negative results. A study wouldn’t be conducted in the first place if there was not some evidence of benefit. However, sometimes studies do end with a negative result. It would take more space than this whole blog to cover the reasons why. As a start, it could have been one of these flaws: the wrong form of the supplement; the wrong dose; too short a time frame; failure to account for confounding factors; the wrong target group; measuring the wrong outcome; or a silly averaging of dissimilar subjects. Occasionally studies are actually designed to fail. Our nurse friend, Carla, sent a link to a hilarious John Oliver program (Last Week Tonight) highlighting some of the foibles of science. I don’t agree with everything John says (e.g. he has “swallowed the Kool-Aid®” regarding a couple of issues) and the language is a bit rough because it is cable. However, the show is entertaining and insightful. LINK

Why the controversy? What possible motive would there be for actually rigging a study to fail? Sometimes one looks as though it might have been a subconscious effort to protect some researcher’s long held bias and reputation. But, more often, the core reason is money. As you can well imagine, it would not be good for the sales of pharmaceutical drugs if people started solving their problems with nutrients, herbs and homeopathics. The extremely lucrative drug industry exerts tremendous direct pressure and subtle indirect influence on research, regulation, medical journals, medical education, medical practice and the media. So, it is much easier for them to cast doubt on a supplement than to prove that their drugs are more effective and safer. (E.g. if all else fails big pharma can conduct a “trial by press release”.) In a rare moment of transparency on the issue, the Food and Drug Administration’s 1992 Task Force Report on Dietary Supplements it stated that dietary supplements represented a “disincentive for patented drug research.” So be it. If a supplement does the work, maybe they should work on a different drug?

Better supplements = better results. There is risk in buying from fly-by-night companies; in falling for excess marketing hype; and in thinking that cost is the key factor in achieving a good value. (A cheap supplement that is not absorbed and well utilized is actually an expensive choice.) It is safest and most productive to stick with great companies that have done their homework. For example, rather than jumping on every popular trend, Jarrow Formulas picks ingredients and ingredient forms that the research supports. Then they hope to educate consumers about their sophisticated formulas. That is properly getting the horse in front of the cart.

You are not average. RDA’s, DRV’s, etc. and other such guidelines come closer to being useful when listing minerals than they do recommending vitamins. Vitamins are safe in typical supplement quantities even when the amounts are multiples of the RDA number. Since one person may need as much as 100 times as much vitamin C as the next person, it usually pays to take more of a vitamin than the very minimum to make sure you are covered. (Vitamin D provides an excellent example of individual variations and I’ll cover that next week.) Even with minerals, the officially recommended dose might not be ideal. For example, some people need more of a mineral because they get less of it in their diet, or they need more due to life style issues or perhaps that mineral form is not well absorbed. Keeping minerals balanced with each other is very important. That is why, unless a person has had tests run, it is safest to consume minerals in a balanced blend formulated by a reputable company.


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