Nutritional Strategies:� Hard Bones, Soft Arteries, Rather Than Vice Versa
ABSTRACT
Nutritional Strategies: The focus of this paper is to explore better strategies for optimizing bone strength and reducing risk of fracture, while at the same time decreasing risk of cardiovascular disease. The majority of Americans do not consume the current recommended dietary allowance for calcium, and the lifetime risk of osteoporosis is about 50%. However, traditional mono-nutrient calcium supplements may not be ideal. We comprehensively and systematically reviewed the scientific literature in order to determine the optimal dietary nutritional strategies and nutritional supplements for long- term skeletal health and cardiovascular health. To summarize, the following steps may be helpful for building strong bones while maintaining soft and supple arteries: (1) calcium is best obtained from dietary sources rather than supplements; (2) ensure that adequate animal protein intake is coupled with calcium intake of 1000 mg/day; (3) maintain vitamin D levels in the normal range; (4) increase intake of fruits and vegetables to alkalinize the system and promote bone health; (5) concomitantly increase potassium consumption while reducing sodium intake; (6) consider increasing the intake of foods rich in vitamins K1 and K2; (7) consider including bones in the diet; they are a rich source of calcium-hydroxyapatite and many other nutrients needed for building bone.
INTRODUCTION: Nutritional Strategies
Calcium: General Physiology Andepidemiology
Calcium is the most ubiquitous mineral in the human body. An average-sized adult body contains approximately 1000 to 1200 g of calcium, which is predominately incorporated into bones and teeth in the form of calcium-hydroxyapatite (Ca10(PO4)6(OH)2) crystals. The remainder circulates throughout the blood and soft tissues, and plays fundamental roles in cell conduction, muscle function, hormone regulation, vitamin (Vit) K-dependent pathways, and cardiac and blood vessel function.1
Some studies indicate only 30% of the US population consumes the Recommended
Dietary Allowance of calcium, which is 1000� 1200 mg daily.1 Furthermore, humans absorb only about 30% of calcium from foods depend- ing on the specific source.1 The body will demineralize its own skeletal system to maintain serum calcium levels in situations where dietary calcium is insufficient and/or absorption is decreased, and/or excretion is increased.2
Osteopenia/Osteoporosis:�An Epidemic
Starting at about age 50 years, postmenopausal women lose about 0.7�2% of their bone mass each year, while men over age 50 years lose 0.5�0.7% yearly. Between ages 45 and 75years, women, on average, lose 30% of their bone mass, whereas men lose 15%.
According to the US Surgeon General�s Report, 1 in 2 Americans over age 50 years is expected to have or to be at risk of develop- ing osteoporosis.3 Osteoporosis causes 8.9 million fractures annually, with an estimated cumulative cost of incident fractures predicted at US$474 billion over the next�20 years in the USA.3�6 Among adult women over age 45 years, osteoporosis accounts for more days spent in hospital than many other diseases such as diabetes, myocardial infarction (MI), chronic obstructive airway disease and breast cancer.3 Fragility fractures are the primary cause of hospitalization and/or death for US adults ? age 65 years and older; and 44% of nursing home admissions are due to fractures.3
A Mayo Clinic study reported that compared to 30 years ago, forearm fractures have risen more than 32% in boys and 56% in girls. The authors concluded that dietary changes, including insufficient calcium and excess phosphate, were significantly associated with increased fractures.7 Public health approaches are crucial to prevent symptomatic bone disease, but widespread pharmacological prophylaxis is prohibitively expensive and carries potential serious adverse effects.
Cardiovascular Disease & Bone Mineral Disease: A Calcium Nexus
Strong epidemiological associations exist between decreased bone mineral density (BMD) and increased risk of both cardiovascular (CV) disease and CV death.8 For example, individuals with osteoporosis have a higher risk of coronary artery disease, and vice versa. This problem will be magnified if the therapies for osteoporosis (eg, calcium supplements) independently increase risk of MI.
Issues With Dairy As Primary Source Of Calcium
Dairy foods and beverages account for about 70% of all dietary calcium intake among Americans. Dozens of epidemiological and randomized controlled trials in adults and children have used dairy products as the principal source of calcium, and have credited dairy intake with preventive benefits on study end points including bone mass, fractures and osteoporosis. A recent meta-analysis of over 270 000 people showed a strong trend for dairy intake protecting against hip fracture; the relative risk (RR) of hip fracture per daily glass of milk was 0.91, 95% CI 0.81 to 1.01.9
In many industrialized nations, milk is often the most cost-effective strategy for achieving recommended levels of calcium intake at a population level. Yet, legitimate concerns exist regarding potential deleterious effects of chronic dairy intake on health.10�16 Dairy foods, on an evolutionary time scale, are relative �new-comers� to the hominin diet.17 Domestication of cattle, sheep and goats first occurred approximately 11 000�10 000 years Before Present.17 Furthermore, it appears that an estimated 65% of the worldwide population expresses the phenotype of lactase non-persistence.18
Consumption of cow�s milk has been inconsistently associated with cataracts, ovarian and prostate cancers, and Parkinson�s disease, and it has been implicated in certain autoimmune diseases, such as type 1 diabetes and multiple sclerosis. Overall, the evidence for dairy-induced human disease appears to be most consistent for prostate cancer and for type 1 diabetes.19
A recent study of over 106 000 adults followed for 20 years showed that drinking three or more glasses of milk per day was associated with increased risks for bone fracture and higher mortality rates compared with drink- ing not more than one glass of milk per day.20 By contrast, for the women in that study, each daily serving of cheese and/or other fermented milk products such as yogurt was associated with a 10�15% decrease in the rates of mortality and hip fractures (p<0.001). However, this was an observational study with inherent limitations such as residual confounding and reverse causation, and thus, firm conclusions cannot be drawn from the data.
The sugar in milk, lactose, is broken down in the gastrointestinal tract to d-galactose and d-glucose. d-Galactose has been found to increase inflammation and oxidation in adult humans, and in adult animals this sugar triggers accelerated aging, neurodegeneration, and a shortened life span.20
Thus, cow�s milk, though rich in many nutrients, including calcium, has issues that render it less than ideal as a dietary staple for many adults. On the contrary, fermented dairy foods, such as yogurt and cheese, appear to be safer than milk, possibly because the most or all of d-galactose has been metabolized by bacteria.20
Plant-Based Dietary Sources Of Calcium & Protein: Effects On Bone Health
Most vegetarians, especially vegans, appear to absorb less calcium because of the oxalic and phytic acid contained in many plant, grain and legume products.1 Indeed, several studies have reported that risks of bone fracture are higher in vegans�likely due, at least in part, to their lower dietary calcium intake, and/or poor absorption of this key mineral (table 1).21
Dietary Protein, Calcium And Bone Health
Evolutionary evidence suggests that preagricultural diets were net base-yielding, and contributed to the robust�bone health generally seen among hunter-gatherers.10 17�By contrast, processed foods displace base-yielding fruits�and vegetables, thereby shifting to a net acid-yielding diet.2 22�24�
Increased protein intake can raise levels of insulin-like growth factor 1, which is anabolic, and contributes to bone building. Experts currently agree that diets moderate in protein (?1.0�1.5 g/kg/day) are associated with normal calcium metabolism, and do not adversely alter bone metabolism; however, at lower protein intakes (<0.8 g/kg/day), intestinal calcium absorption is reduced and levels of parathyroid hormone rise, causing the mobilization of calcium from bone.25 26
A growing body of evidence indicates that diets higher in animal protein associate with greater bone mass and fewer fractures, particularly if the calcium intake is also sufficient (approximately 1000 mg of calcium/day) (figure 1).26�28 Thus, a diet providing ample dietary calcium, along with alkalizing nutrients, such as fruits and vegetables, and possibly also alkaline mineral waters, may create a milieu where moderate intake of animal protein contributes favorably to bone health. Additionally, intake of protein plus calcium with Vitamin D may reduce fracture rates through mechanisms independent of bone density.29
Magnesium
Maintaining replete magnesium status may reduce risk for the metabolic syndrome, diabetes, hypertension and MI.30 Circumstantial and experimental evidence has also implicated magnesium deficiency in osteoporosis.31�34 Optimal dietary magnesium intake is about 7�10 mg/ kg/day, preferably in the context of a net base-yielding diet, since a net acid-yielding diet increases excretion of both magnesium and calcium (table 2).
Potassium/Sodium Ratio Affects Calcium Metabolism
A potassium/sodium ratio of 1.0 or higher is associated with a 50% lower risk of CVD and total mortality com- pared with a ratio under 1.0.35 Reducing excessive sodium intake is also associated with resultant decreased urinary calcium excretion, which may help to prevent against bone demineralization.36 The average potassium content (about 2600 mg/day) of the typical US diet is substantially lower than its sodium content (about 3300 mg/day).35 Approximately 77% of dietary sodium chloride is consumed in the form of processed foods. By contrast, potassium is naturally abundant in many unprocessed foods, especially vegetables, fruits, tubers, nuts, legumes, fish and seafood. In fact, a high potassium/sodium ratio is a reliable marker for high intake of plant foods and lower intake of processed foods.35 High dietary sodium intake has been associated with endothelial damage, arterial stiffness, decreased nitric�oxide production and increased levels of transforming growth factor ?; whereas, high potassium dietary intake can counteract these effects.35 36
Evidence indicates that the lowest CV event rates occur in the moderate sodium excretion and high potassium excretion groups.37 Thus, it appears that a moderate sodium diet (2800�3300 mg/day) in conjunction with a high potassium intake (>3000 mg/day) might confer the optimal CV benefits for the general population.37
Vitamin K & Bone Health
Emerging evidence suggests that Vitamin K may confer protective effects for both the skeletal and CV systems. Vitamin K operates in the context of other fat-soluble vitamins, such as A and D, all of which are involved in maintenance of serum calcium concentration, along with the manipulation of materials leading to bone morphogenesis and maintenance of bone tissue.38 Specifically, the oxidation of Vitamin K results in activation/carboxylation of matrix Gla protein (MGP) which is partially responsible for mineralizing bone.39
Also, Vit K is required for the activation (?-carboxylation) of osteocalcin; the inactivated form, or per cent of undercaboxylated-osteocalcin (%ucOC), has been found to be a sensitive indicator of Vitamin K nutrition status.38 In cross-sectional and prospective analyses, elevated %ucOC, which occurs when Vitamin K status is low, is a marker of increased risk for hip fracture in the elderly.38
Several large observational studies appear to support the benefits of Vitamin K on bone health.38 A meta-analysis concluded that while supplementation with phytonadione (Vitamin K1) improved bone health, Vitamin K2 was even more effective in this regard.40 This large and statistically rigorous meta-analysis concluded that high Vitamin K2 levels were associated with reduced vertebral fractures by approximately 60% (95% CI 0.25% to 0.65%), hip fractures by 77% (95% CI 0.12% to 0.47%), and all non- vertebral fractures by approximately 81% (95% CI 0.11% to 0.35%). Moreover, the benefit of Vitamin K on bone may not be due to its ability to increase BMD, but rather to its effects at increasing bone strength.41
Vitamin K Benefits In CV Health
Mounting evidence suggests vascular calcification whether in the coronary or peripheral arteries is a powerful predictor of CV morbidity and all-cause mortal- ity.42 Prevention of vascular calcification is therefore important as an early intervention to potentially improve long-term CV prognosis.
A major calcification inhibitory factor, is a Vitamin K-dependent protein synthesized by vascular smooth muscle cells.42 Increased
Vitamin K2 intake has been associated with decreased arterial calcium deposition and the ability to reverse vascular calcification in animal models. Vitamin K2 prevents pathological calcification in soft tissues via the carboxylation of protective MGP. The undercarboxylated (inactive) species of MGP is formed during inadequate Vitamin K status, or as a result of Vitamin K�antagonists.42 Low Vitamin K status is associated with increased vascular calcifications, and can be improved by effective Vitamin K supplementation (table 3).43 44 In two different randomized, double-blind controlled trials, supplemental Vitamin K has been shown to significantly delay both the development of coronary artery calcification and the deterioration of arterial elasticity.45 46
Dietary Vitamin K exists as two major forms: phylloquinone (K1) and menaquinones (MK-n). K1, the predominant dietary form of Vitamin K, is abundant in dark-green leafy vegetables and seeds. The main dietary sources for MK-n in Western populations are fermented foods, especially natto, cheese and curds (mainly MK-8 and MK-9).47
Calcium Supplementation & Bone Health
A recent large meta-analysis of 26 randomized controlled trials reported that calcium supplements lowered the risk of any fracture by a modest but statistically significant 11% (n=58 573; RR 0.89, 95% CI 0.81 to 0.96).48 Even so, the authors concluded that the evidence for calcium supplements on bone health was weak and inconsistent.
Other large meta-analyses found that calcium supplementation was most effective for preventing hip fractures when it was combined with Vitamin D.49�51 Indeed Vitamin D plays a major role in intestinal calcium absorption and bone health (figure 2).52 Additionally, calcium absorption is, in part, dependent on adequate stomach acid, and both these parameters tend to decrease with age. Drugs that markedly reduce stomach acid, such as proton pump inhibitors, have been shown to reduce calcium absorption and increase risk of osteoporosis and fractures.53
A large meta-analysis focusing on calcium intake and fracture risk found that in women (seven prospective cohort studies=170 991 women, 2954 hip fractures), there was no association between total calcium intake and hip fracture risk (pooled RR per 300 mg total=1.01; 95% CI 0.97 to 1.05).50 In men (five prospective cohort studies= 68 606 men, 214 hip fractures), the pooled RR per 300 mg of calcium daily was 0.92 (95% CI 0.82 to 1.03).
Monosupplementation with calcium, especially using the most commonly prescribed formulations (calcium carbonate and calcium citrate) might drive down the absorption of phosphate, thereby contributing to bone demineralization secondary to abnormal calcium to phosphate ratios.54 The recently updated US Preventive Services Task Force (USPSTF) has stated that there is insufficient evidence that calcium and Vitamin D prevent fractures in premenopausal women or in men who have not experienced a prior fracture. Indeed, the USPSTF now recommends against daily calcium supplementation for primary prevention of fragility fractures; stating, �the balance of benefits and harms cannot be determined�.55
Calcium Supplementation & Arterial Health
The Women�s Health Initiative, a 7-year, placebo- controlled randomized trial involving 36 282 participants, found that calcium supplementation with Vitamin D�(1000 mg/400 IU daily) had a neutral effect on coronary risk and cerebrovascular risk.56 By contrast, some subsequent publications have reported data challenging the CV safety of calcium supplementation.57�60
One meta-analysis of placebo-controlled trials involving 28 000 participants reported that a daily calcium supplement was associated with an increased risk of MI (HR 1.24, 95% CI 1.07 to 1.45, p=0.004).58 A prospective study of 388229 men and women with a 12-year follow-up showed that calcium supplementation was associated with elevated risk of heart disease death in men, but not in women.61 Yet, only one randomized controlled trial of calcium supplementation using adverse cardiac events as the primary end point has been published. In that study, daily supplementation using 1200 mg of calcium carbonate did not increase the risk of CV death or hospitalization for 1460 women (mean age 75 years).62
In a prospective cohort study with a mean follow-up of 19 years, both�high and low dietary calcium intakes were associated with increased CV disease and higher all-cause mortality (figure 3).51 Importantly, a low dietary calcium intake with or without calcium supplementation is also associated with higher CV morbidity and mortality rates.51
Other possible mechanisms that have linked calcium supplements with CV disease include coronary artery calcification, impaired vasodilation, increased arterial stiffness, and hypercoagulability.51 66
Nutritional Strategies: Food As The Ideal Source Of Calcium
The traditional focus in nutritional strategies based on supplementation of single isolated nutrients may be especially mis- guided in the case of calcium and bone health. A diet supplemented with calcium as a mononutrient pill is not ideal for promoting bone health, and may instead accelerate arterial plaque growth and vascular calcification, and increase risk of MI. Food-based solutions place evidence-based emphasis on finding the admixture of foods that balance the acid�base status of the body, and that most favorably impact the body�s calcium metabolism and bone health.
A plant-rich, grain-free diet alters the acid�base status so as to be slightly alkaline, which is conducive for bone health. However, plants are relatively poor sources of calcium compared to animal sources such as dairy pro- ducts and animal bones. We suspect that milk, though an excellent source of bioavailable calcium, has potential adverse health effects for some individuals. Additionally, 65% of the world�s population show some decrease in lactase activity during adulthood. Importantly, fermented dairy has been linked to favorable outcomes for bone health and mortality risk.
Benefits Of Consuming Bones Or Bone Meal
Ethnographic and anthropological studies indicate that adult human hunter-gatherers consumed most of their calcium in the form of bones from animals, such as small and large mammals, birds, fish and reptiles.67 68 Indeed through millions of years of evolution, we are genetically adapted to consume a large proportion of our dietary calcium from bones, where calcium is absorbed along with a matrix of nutrients including magnesium, phosphorus, strontium, zinc, iron, copper, collagen protein, aminoglycans and osteocalcin�all of which also support robust bone formation.68 69 Theoretically, including animal bones (sardines, salmon, soft chicken bones, bone broths, etc) may be an effective dietary strategy to ensure adequate calcium intake and to optimize long-term bone health.
Mineral supplements made from bone meal, when taken with food, theoretically might provide a more practical means to ensure
adequate calcium intake without predisposing to CVD risk. Ingestion of micro- crystalline hydroxyapatite (the form of calcium found in bone) produces less of an acute spike in blood calcium levels compared to soluble calcium salts typically used in standard supplements, and thus may be less likely to increase vascular calcification and coronary risk.65 Hydroxyapatite also stimulates bone osteoblast cells and contains virtually all the essential building blocks needed to construct bone tissue. In a small placebo- controlled randomized trial, women who took 1000 mg of calcium in the form of hydroxyapatite in conjunction with oral Vitamin D showed a significant increase in bone thickness, whereas those who took 1000 mg of a standard calcium carbonate supplement did not (figure 4).70 Another double-blind placebo-controlled study found�that supplementing with hydroxyapatite and Vitamin D3 significantly improved serological markers of bone health.15
In theory, the addition of Vitamin K2 and magnesium to an organic bone meal supplement might further enhance its effectiveness and reduce the risk of soft tissue calcification. However, the quantity and quality of the experimental data testing the effects of Vitamin D and calcium on bone health dwarfs the data for bone meal supplementation. Much larger randomized trials will be needed to firmly establish the safety and effectiveness of bone meal as well as Vitamin K and magnesium as supplements for building bone without increasing vascular calcification.
Conclusion: Nutritional Strategies
It is becoming increasingly clear that the fundamental unit for nutrition is the food (eg, milk, nuts, eggs), not the nutrient (eg, calcium, saturated fat, cholesterol). A nutrient perceived as beneficial, such as calcium, may be unhealthy if the parent food, say milk, contains other nutrients, such as galactose, that on the balance might stimulate adverse effects in the body. In theory, consuming calcium-rich foods such as bones, fermented dairy (eg, unsweetened yogurt, kefir, cheese), leafy greens, almonds, and chia seeds may be an effective strategy for improving both calcium intake and long-term health.
James H O�Keefe,1 Nathaniel Bergman,2 Pedro Carrera-Bastos,3 Mae?lan Fontes-Villalba,3 James J DiNicolantonio,1 Loren Cordain4
Twitter Follow Maela?n Fontes-Villalba at @maelanfontes
Contributors NB, PC-B and MF-V assisted with the gathering and review of the data; JD, LC and JHO reviewed the data; NB, PC-B, MF-V, JD, LC and JHO assisted in the concept and design of the manuscript. JHO, NB and PC-B wrote, rewrote and finalised the manuscript.
Funding This manuscript received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. This paper was not commissioned.
Competing interests JHO is Chief Medical Officer and has an ownership interest in CardioTabs, a nutraceutical company that markets products containing vitamins and minerals.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement No additional data are available.
Open Access This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non- commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http:// creativecommons.org/licenses/by-nc/4.0/
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There’s something about gastrointestinal issues that makes them difficult to talk about in polite company, which unfortunately leaves many of us suffering one problem or another in silence. “What’s more, gastrointestinal, or GI, diseases are putting an increasing weight on Americans, causing an unprecedented number of clinical visits and hospitalizations than ever before”, stated Stephen Bickston, an American Gastroenterological Association professor of internal medicine at Virginia Commonwealth University.
What are the most prevalent gastrointestinal diseases?
Nevertheless, treatments for gastrointestinal diseases can be as simple as making informed lifestyle modifications or even taking over-the-counter drugs and medications. Peppermint oil and soluble fiber, for instance, has been used to help people with irritable bowel syndrome, or IBS, where a 2008 British Medical Journal study suggested that both of these natural remedies ought to be first-line treatment therapies for IBS. Here’s a rundown of the latest medical knowledge on five of the most common gastrointen.
Acid Reflux
Symptoms of acid reflux, such as heartburn, are among several of the most common digestive discomforts reported by the general population. In a Swedish study, approximately 6 percent of people reported suffering from acid reflux symptoms daily and 14 percent had them at least weekly. Such frequent symptoms may indicate the presence of gastroesophageal reflux disorder, or GERD. Aside from being painful, GERD, or gastroesophageal reflux disorder can damage the esophagus throughout the years or even lead to esophageal cancer.
“Heartburn typically involves a hot or burning sensation which rises up from the center of the abdomen area and to the chest under the breastbone or sternum”, states Michael Gold, a gastroenterologist at MedStar Washington Hospital Center in Washington, D.C. “It might also be accompanied by a sour taste in the mouth, or hypersalivation, in addition to discovering fluid or food out of your mouth, particularly at night time.” Pregnancy, several drugs and medications, as well as consuming alcohol or certain foods can cause heartburn. Children under the age of 12 and a few adults may have GERD without heartburn, instead experiencing asthma-like symptoms, difficulty swallowing, or a dry cough.
Treatment options for acid reflux include drugs and medications that reduce acid levels, like the proton pump inhibitors Aciphex, Nexium, Prevacid, Prilosec, and Protonix, along with the H2 blockers Axid, Pepcid, Tagamet, and Zantac. But taking these drugs and/or medications is not without risk. In 2008, a study found that a proton pump inhibitor can weaken the heart-protective impact of the blood thinner Plavix in patients taking the two drugs/medications together. In severe cases of gastroesophageal reflux disorder, surgeons can tighten a loose muscle found between the esophagus and the stomach, to inhibit the upwards flow of gastric acid. Laparoscopic surgery, which involves small incisions, has been proven to reduce scarring and shorten recovery time in comparison with open procedures.
Diverticulitis
By one estimate, about 3 in 5 Americans older than 70 years of age have the abnormal lumps called diverticula someplace in the wall of their intestinal tract. However, only 20 percent may experience a complication like diverticulitis, inflammation of a pouch, a tear, or an abscess.
Individuals with Crohn’s disease or ulcerative colitis, the two most prevalent inflammatory bowel diseases, complain of abdominal pain and diarrhea and may sometimes experience anemia, rectal bleeding, weight loss and other symptoms. “No definitive tests and evaluations exist for either disease and patients generally endure two primary misdiagnoses”, says R. Balfour Sartor, chief medical adviser to the Crohn’s & Colitis Foundation of America. “With Crohn’s”, he states, “appendicitis, irritable bowel syndrome, an ulcer, or an infection can be incorrectly diagnosed.”
In case diverticulitis does develop, symptoms are most likely to manifest through abdominal pain and potentially fever, however, antibiotics can treat the problem. In severe instances, a tear can result in an abscess, which might result in nausea, vomiting, fever, and intense abdominal tenderness which demands surgical repair. Some healthcare specialists consider that a diet too low in fiber could trigger the gastrointestinal disease, which develops growingly common with age and is most widespread in western societies.
Inflammatory Bowel Disease
Both disorders may emerge from a wayward immune system that leads the body to attack the gastrointestinal tract, or GI tract. Crohn’s disease involves ulcers that could seep deep into the tissue lining at any given section of the GI tract, leading to infection and thickening of the intestinal wall and blockages which may need surgery. Ulcerative colitis, by comparison, interrupts only the colon and rectum, where it also causes ulcers; colitis is characterized by bleeding and pus.
Treating either disease requires beating back, then constantly holding in check, the inappropriate inflammatory response. Both steps are accomplished by means of a combination of prescription anti-inflammatories, steroids and immunosuppressants. Crohn’s patients might also be given antibiotics or other specialized drugs and medications. The current debate stands as to whether Crohn’s disease sufferers benefit if given highly potent treatment therapies early in the course of the gastrointestinal disease instead of escalating potency with time from milder initial treatments, as is traditionally done, clarified Themos Dassopoulos, manager of inflammatory bowel diseases at Washington University at St. Louis. Surgery “cures” ulcerative disorders by simply taking away the colon but signifies that patients will need to wear a pouch, internally or externally, for waste. “Inflammatory bowel disease, or IBD, patients must take particular caution when using NSAIDs, such as aspirin, since these painkillers may cause additional gut inflammation in 10 to 20 percent of individuals, ” states Dassopoulos.
Constipation
The fact that Americans spend $725 million annually on laxatives indicates that trying to unclog the nation’s plumbing, so to speak, is a national pastime. But overuse of stimulant laxatives, which cause the intestines to contract rhythmically, can make the gut more reliant on these, requiring more of them and finally rendering the aid ineffective. First, a little bit of clarification on the frequency of your flushing: “There is no need to worry about having a daily bowel motion; anywhere between three times a day and three times per week is normal”, says Sandler.
“However, if you are having discomfort and can not make your bowels move, try out an over-the-counter remedy such as milk of magnesia’,’ he states. And should you have attempted laxatives or not, going a week without a bowel movement is a very good reason to see the doctor, ” says Sandler. Constipation, hard stools, and straining could result in hemorrhoids or an anal fissure. Constipation is best avoided through regular exercise and a diet high in fiber from whole grains, fruits, and vegetables. To elderly folks, that are inclined to become constipated more frequently: Be sure you’re hydrating properly and conscious of any drugs and medications which may be causing your bowel movements to be backed up.
Gallstones
Just a quarter of people with gallstones typically require treatment. That’s fortunate, because every year nearly 1 million Americans are diagnosed with these small pebbles, which are largely made of cholesterol and bile salts. Eliminating these typically requires removal of the gallbladder, one of the most frequent surgeries in the United States.
“Gallstones can get blamed for symptoms caused by other, more elusive culprits, such as irritable bowel syndrome”, states Robert Sandler, chief of the division of gastroenterology and hepatology together with the University of North Carolina School of Medicine. An ultrasound evaluation may pick them up while missing the real issue. “If you’re told you’ve got to have gallstones out however they aren’t bothering you, get a second opinion”, he advises. Removal may be mandatory when the stones instigate infection or inflammation of the gallbladder, pancreas, or liver. This can happen if a stone going out of the intestine becomes trapped, blocking the flow of bile, at the ducts between the liver and the small intestine.
The pain of a gallstone lodged at a duct normally comes on quickly at the right upper abdomen, between the shoulder blades, or beneath the right shoulder,� and also means a visit to the ER is necessary, as may fever, vomiting, nausea, or pain lasting more than five hours. Gallbladder removal may be accomplished laparoscopically and more recently has been completed with no external incision by going through your mouth or vagina. Obesity can also be a risk factor for gallstones, and it is theorized that they increase due to a lack of fiber and an excessive amount of fat from the western diet. Losing weight then regaining it also seems to set the stage for the common gastrointestinal disease. In a 2006 study of men, the more frequent the weight cycling and the bigger the amount of pounds fall and are regained, the larger the chances of developing gallstones. Women, in particular those people who are pregnant or using birth control pills, face an increased risk of developing gallstones as well.
We will continue to discuss the common issues affecting the gastrointestinal tract, or GI tract, including the colon as well as rectum and anal problems, in the following series of articles. The 5 common gastrointestinal diseases mentioned above can manifest pain and discomfort as well as a variety of other symptoms if left untreated. Be sure to seek proper medical attention. The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
By Dr. Alex Jimenez
Additional Topics: Wellness
Overall health and wellness are essential towards maintaining the proper mental and physical balance in the body. From eating a balanced nutrition as well as exercising and participating in physical activities, to sleeping a healthy amount of time on a regular basis, following the best health and wellness tips can ultimately help maintain overall well-being. Eating plenty of fruits and vegetables can go a long way towards helping people become healthy.
Food is one of the most essential basic needs. It is made up of nutrients, micronutrients, such as vitamins and minerals, and macronutrients, such as carbohydrates, proteins and fats. A balanced diet, consisting of a variety of these nutrients is the foundation of good health. While consuming the necessary daily intake of carbohydrates, high-quality proteins, heart-healthy fats, vitamins, minerals and water is essential towards maintaining the body’s overall well-being and function, staying healthy and productive could not be achieved without one important structure: the digestive system.
What is the digestive system?
The digestive system is a collective group of organs which function together to convert food into energy and provide basic, fundamental nutrients in order to nourish the entire body. Food is delivered through a long tube inside the body known as the alimentary canal, best referred to as the gastrointestinal tract, or the GI tract. The gastrointestinal tract consists of the oral cavity, or mouth, pharynx, esophagus, stomach, small intestines, and large intestines. Along with the gastrointestinal tract, there are various important accessory organs which additionally help the human body to digest foods, however, these do not have food pass through them. Accessory organs of the digestive system include the teeth, the tongue, salivary glands, liver, gallbladder, and the pancreas.
Digestive System Anatomy
Mouth
Food begins its course through the digestive system at the mouth, also known as the oral cavity. As a matter of fact, digestion is considered to begin here as soon as you take the first bite of a meal. Within the mouth are numerous accessory organs which aid in the digestion of food: the teeth, the tongue, and the salivary glands. Teeth chop food into smaller pieces, to allow for an easier digestion, which are then moistened by saliva to begin the process of breaking the food down, before the tongue and other muscles of the mouth push the food into the pharynx.
Teeth. The teeth are 32 small, hard organs located along the anterior and lateral edges of the mouth. Each tooth is created from a bone-like material called dentin and coated in a layer of enamel, the hardest substance in the human body. Teeth are living organs that also contain blood vessels and nerves under the dentin in a soft region, best referred to as the pulp. The structure of the teeth is made for cutting and grinding food into smaller pieces.
Tongue. The tongue is located on the inferior section of the mouth only posterior and medial to teeth. It’s a small organ composed of several pairs of muscles coated in a thin but strong, bumpy, skin-like layer. The outside of the tongue contains many papillae designed for grasping food as it’s moved by the tongue’s muscles. The taste buds on the surface of the tongue distinguish flavor molecules in food and link to nerves in the tongue to deliver taste information to the brain. The tongue can also help push food toward the posterior area of the mouth for swallowing.
Salivary Glands. Surrounding the mouth are three varieties of salivary glands. The salivary glands are sets of accessory organs that produce a watery secretion known as saliva. Saliva helps to moisten food and starts the digestion of food. The body also uses saliva to continue lubricating food as it moves through the mouth, pharynx, and esophagus.
Pharynx
The pharynx, or throat, is a funnel-shaped tube connected to the back end of their mouth. The pharynx is responsible for the delivery of a mass of chewed food from the mouth to the esophagus. The pharynx also has a significant role in the respiratory system, as air from the nasal cavity passes through the pharynx on its way to the larynx and finally the lungs. Since the pharynx serves two different functions, it includes a flap of tissue called the epiglottis which behaves as a switch to effectively route food into the esophagus and air into the larynx.
Esophagus
The esophagus is a muscular tube which connects the pharynx to the stomach, that is part of the upper gastrointestinal tract, or upper GI tract. By means of a series of contractions, referred to as peristalsis, it transports the eaten masses of chewed food along its span. At the inferior end of the esophagus is a muscular ring known as the lower esophageal sphincter or cardiac sphincter. The role of the sphincter is to shut off the end of the esophagus and keep food from passing backwards into the esophagus, and instead maintain it in the stomach.
Stomach
The stomach is a muscular sac that’s located on the left side of the abdominal cavity, just inferior to the diaphragm. In an average individual, the stomach is about the size of their two fists placed alongside each other. This major organ plays the role of serving as a sort of storage tank for foods so the body has enough time to digest large meals properly. The stomach also contains hydrochloric acid and digestive enzymes which continue the digestion of food that began from the mouth. When it leaves the stomach, food is the consistency of a liquid or paste.
Small Intestine
Made up of three segments, the duodenum, the jejunum and the ileum, the small intestine is a long, thin tube about 1 inch in diameter and approximately 10 feet long which is part of the lower gastrointestinal tract, or lower GI tract. It is located only inferior to the stomach and takes up nearly all the space in the abdominal cavity. The entire small intestine is coiled like a hose and the interior surface is filled with lots of ridges and folds. These folds are utilized to make the most of the digestion of food and absorption of nutrients. The small intestine continues the process of breaking down food with the help of accessory organs. Contractions known as peristalsis are also at work within this organ. By the time food leaves the small intestine, approximately 90 percent of nutrients are extracted from the food which entered it.
Liver and Gallblader
The liver is a roughly triangular accessory organ of the digestive system found to the right of the stomach, just inferior to the diaphragm and superior to the small intestine. The liver weighs about 3 pounds and is the second largest organ in the human body. The liver has many different functions, but its primary purpose is the production of bile and its secretion into the small intestine for digestion. Another of its important functions include the cleansing and purification of the blood flowing from the small intestine, which contains the absorbed nutrients. The gallblader is a small, pear-shaped organ found just posterior to the liver. The gallbladder is used to store and recycle surplus bile from the small intestine, through a channel known as the cystic duct, so that it might be re-utilized for the digestion of subsequent meals.
Pancreas
The pancreas is a large gland situated just inferior and posterior to the stomach. It is approximately 6 inches long and shaped like short, lumpy snake with its “head” attached into the duodenum and its “tail” pointing towards the left wall of the abdominal cavity. The pancreas secretes digestive enzymes into the small intestine to complete the digestion of foods. These enzymes break down carbohydrates, proteins and fats from the food we eat.
Large Intestine
The large intestine, best referred to as the colon, is a long, thick tube about 2.5 inches in diameter and approximately 5 feet long.�It is made up of the cecum, the ascending colon, the transverse colon, the descending colon, and the sigmoid colon, which connects to the rectum. It is located only inferior to the stomach and wraps across the lateral and superior border of the small intestine. The large intestine absorbs water and also contains many symbiotic bacteria which aid in the breaking down of wastes to extract small quantities of nutrients. Stool, or waste left over from the digestive process, is passed through the colon by means of peristalsis, or contractions, first in a liquid state and ultimately in solid form as the water is removed from the stool. Stool, or feces, in the large intestine exits the body through the anal canal, to begin the process of elimination.
In conclusion, the digestive system is ultimately essential to effectively break down the food we consume to provide our body with energy and basic nutrients. Unfortunately, however, as with other systems of the body, gastrointestinal diseases can alter the healthy function of the digestive system. The gastrointestinal tract may appear normal but may not be working properly. Symptoms can vary widely on the individual depending on the problem.� We will discuss the common issues affecting the gastrointestinal tract, or GI tract, including the colon as well as rectum and anal problems, in the following series of articles.�The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
By Dr. Alex Jimenez
Additional Topics: Wellness
Overall health and wellness are essential towards maintaining the proper mental and physical balance in the body. From eating a balanced nutrition as well as exercising and participating in physical activities, to sleeping a healthy amount of time on a regular basis, following the best health and wellness tips can ultimately help maintain overall well-being. Eating plenty of fruits and vegetables can go a long way towards helping people become healthy.
Calcium is one of the most omnipresent mineral in the human body. An average-sized adult’s body, for instance, can contain approximately 1000 to 1200 grams of calcium, which is generally, invisibly integrated into bones and teeth by the widely available type of mineral, identified as calcium-hydroxyapatite (Ca10(PO4)6(OH)2) crystals. The rest circulates throughout the blood and soft tissues, as it plays fundamental roles in cell conduction, muscle function, hormone regulation and vitamin K-dependent pathways, as well as for proper cardiac and blood vessel function.
What role does calcium play in heart health?
Several research studies indicate that just about 30 percent of the United States population consumes the Recommended Dietary Allowance of calcium, which calls for approximately 1000 to 1200 milligrams on a regular daily basis. Furthermore, humans can absorb only about 30 percent of calcium from foods, based on the particular source. The body will in turn, demineralize its own skeletal system to maintain the proper serum calcium levels in scenarios where dietary calcium is inadequate and/or absorption is decreased, and/or excretion is increased.
Epidemic of Osteopenia/Osteoporosis
Starting at around the age of 50 years old, postmenopausal women lose about 0.7 to 2 percent of their bone mass each year, while men over age 50 years lose 0.5 to 0.7 % annually. Between ages 45 and 75 years of age, women lose 30 percent bone mass, whereas men lose 15 percent.
According to the US Surgeon General’s Report, one in two Americans over the age of 50 are expected to have an increased risk of developing osteoporosis. Osteoporosis causes 8.9 million fractures annually, with an estimated cumulative cost of incident fractures predicted at US $474 billion over the next 20 years. Among mature women over the age of 45, osteoporosis accounts for more days spent in the hospital than many other conditions and diseaes, such as diabetes, myocardial infarction (MI), chronic obstructive airway disease and even breast cancer. Fragility fractures are the primary cause of hospitalization and/or death for US adults age 65 years and older; and 44 percent of nursing home admissions are caused by fractures.
A Mayo Clinic study noted that compared to 30 years ago, forearm fractures have increased more than 32 percent in men and 56 percent in women. The authors of the research study concluded that dietary changes, such as inadequate calcium and extra phosphate, were considerably associated with increased fractures. Public health approaches are critical to prevent symptomatic bone disease, however, widespread psychiatric prophylaxis is prohibitively costly and carries potentially serious adverse effects.
Cardiovascular Disease and Bone Disease
Strong epidemiological associations exist between decreased bone mineral density (BMD) and increased risk of the cardiovascular disease (CVD) and CVD death. For instance, individuals with osteoporosis have been reported to have a higher risk of developing coronary heart disease (CHD), as well as cardiovascular disease. This issue will be magnified if the remedies for osteoporosis (eg, calcium supplements) separately increase the risk of MI.
Issues with Dairy as Primary Source of Calcium
Dairy foods and drinks account for about 70 percent of dietary calcium intake among Americans. Dozens of epidemiological and randomized controlled trials in adults and children have utilized dairy products as the main source of calcium, and have credited dairy intake with preventive benefits on study end points such as bone mass, fractures and osteoporosis. A current meta-analysis of over 270,000 people revealed a strong trend for dairy intake protecting against hip fracture; the relative risk (RR) of hip fracture each day glass of milk was 0.91, 95 percent CI 0.81 to 1.01.
In most industrialized countries, milk is frequently the most cost-effective strategy for achieving recommended levels of calcium consumption in a population level. However, legitimate concerns exist regarding potential deleterious effects of chronic dairy intake on health. Dairy foods, on a time scale, are relative new-comers to the hominin diet. Domestication of cattle, sheep and goats first happened approximately 11,000 to 10,000 years ago. Furthermore, it seems that an estimated 65 percent of the global population expresses the pheno-type of lactase non-persistence.
Consumption of cow’s milk has been inconsistently associated with cataracts, ovarian and prostate cancers, and Parkinson’s disease, as it’s also been implicated in certain autoimmune diseases, such as type 1 diabetes and multiple sclerosis. Overall, the evidence for dairy-induced human diseases seems to be consistent for prostate cancer and for type 1 diabetes. A recent study of over 106,000 adults followed for 20 years showed that drinking three or more glasses of milk per day was associated with increased risks for bone fracture and higher mortality rates in comparison to ingesting more than 1 glass of milk every day. By comparison, for the women in that study, daily serving of cheese and/or other fermented milk products such as yogurt was associated with a 10 to 15 percent decrease in the rates of mortality and hip fractures (p<0.001). However, this was an observational study with inherent constraints such as residual confounding and reverse causation. In conclusion, solid results cannot be drawn in the data.
The sugar in milk, lactose, is broken down in the gastrointestinal tract into d-galactose and d-glucose. D-Galactose has been proven to increase inflammation and oxidation in adult humans, and in mature animals this sugar triggers accelerated ageing, neurodegeneration, and a shortened life span. Therefore, cow’s milk, even though rich in many nutrients,including sodium, has issues that leave it less than ideal as a dietary staple for most adults. On the contrary, fermented milk foods, such as cheese and yogurt, appear to be safer than milk, perhaps because the mostor all of d-galactose has been metabolized by bacteria, to make these staple food products.
Calcium, as with many other vitamins and minerals, is a fundamental compound needed to support the proper function of the human body, particularly when it comes to cardiovascular disease and heart health. Although these results have been displayed in several research studies, it’s essential to consult a healthcare professional to discuss your nutritional options. The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
By Dr. Alex Jimenez
Additional Topics: Wellness
Overall health and wellness are essential towards maintaining the proper mental and physical balance in the body. From eating a balanced nutrition as well as exercising and participating in physical activities, to sleeping a healthy amount of time on a regular basis, following the best health and wellness tips can ultimately help maintain overall well-being. Eating plenty of fruits and vegetables can go a long way towards helping people become healthy.
Coenzyme Q10, or CoQ10, ranks among the best selling nutritional supplements, with global sales forecast to reach $849 million by 2020, according to a recent study. Researchers report that Coenzyme Q10 may have important benefits for those who have cardiovascular disease, or CVD, from reducing the risk of repeated heart attacks and improving outcomes in patients with heart failure, to reducing high blood pressure, or BP, and helping combat side ramifications of cholesterol-lowering statins.
What are the heart health benefits of Coenzyme Q10?
There’s also evidence that CoQ10 might have “important protective heart health effects” that might help prevent CVD, the world’s leading cause of death, reports a recent study published in Cardiovascular Pharmacology: Open Access. As these are fascinating findings, messaging to individuals around CoQ10, especially in the popular media, is frequently confusing, resulting in less than optimum results and inadequate supplement option. Here’s a guide to the most recent discoveries about the heart health benefits of CoQ10 and how to make smart choices in selecting supplements.
What is Coenzyme Q10?
Found in almost every cell of the body, Coenzyme Q10 is a fat-soluble, vitamin-like substance that helps convert food into energy. A potent antioxidant that protects against harm from toxic free radicals, CoQ10 is naturally created by the human body and can also be found in many foods, with high levels found in organ meats, like liver or kidneys; as well as in sardines, mackerel, chicken, cauliflower, broccoli and asparagus.
What are the Different Forms of CoQ10?
There are two kinds of CoQ10: ubiquinone and ubiquinol. Ubiquinol, the active antioxidant form of Coenzyme Q10, is created within the human body from ubiquinone. As we age, the amounts of both kinds drop. As early as age 20, the quantity of ubiquinone our own bodies produce starts to drop. Compounding the issue, the entire body also loses its ability to generate ubiquinol out of ubiquinone. Most dietary supplements comprise ubiquinone and therefore are relatively economical, whilst ubiquinol nutritional supplements, which may be of most benefit as we age, may be harder to find and more expensive.
A simple blood test can be obtained to measure CoQ10 levels. A shortage of this antioxidant may result in oxidative stress, which raises the risk of a variety of disorders, including cardiovascular disease. Recent research links low blood levels of CoQ10 with reduced levels of heart-protective “good” cholesterol which in turn can further increase risk for heart disease. Cholesterol-lowering statins may also reduce blood levels of CoQ10.
What’s the Physiological Role of Coenzyme Q10?
Coenzyme Q10, or CoQ10, best referred to as ubiquinone, can possibly enhance function by means of many different mechanisms. CoQ10 is a highly lipophilic molecule made up of a 1,4-benzoquinone. The Q describes the quinone chemical groups and the 10 describes the amount of isoprenyl chemical subunits in its tail. CoQ10 belongs to a group of chemicals which are characterized by their quinone moieties along with the length and composition of their hydrophobic tails. Even though being a frequent element of most cellular membranes, CoQ10’s most prominent role is to facilitate the production of ATP by participating in redox reactions within the electron transport chain in the mitochondria. Over the electron transfer chain, CoQ10 accepts electrons from complexes I and II and transports them to complex III. Now, it is ready to be decreased by complexes I and II again.
Along with its crucial role as a component of the electron transport chain, CoQ10 can be safely considered to be a potent antioxidant. CoQ10 was shown to inhibit the peroxidation of cell membrane lipids and reduces the oxidation of circulating lipolipids. In vitro analysis demonstrated that supplementation with CoQ10 inhibited low-density lipoprotein oxidation into a significantly greater level compared with other natural antioxidants, such as ?-carotene or ?-tocopherol. In apolipoprotein E–deficient mice fed with a high fat diet, CoQ10 supplementation decreased the concentration of lipid hydroperoxides in atherosclerotic lesions and reduced the size of atherosclerotic lesions in the aorta.
As well as its antioxidant action, Coenzyme Q10 also appears to enhance endothelial function. In vitro investigations in human umbilical vein endothelial cells revealed that Coenzyme Q10 supplementation reduced oxidized low-density lipoprotein–triggered endothelin-1 (a known potent vasoconstrictor) secretion. Furthermore, CoQ10 supplementation enhanced nitric oxide bioavailability and decreased cytochrome c (necessary for activation of proapototic proteins) secretion.
How Does CoQ10 Directly Affect Heart Health?
Recent research indicates that Coenzyme Q10, either alone or blended with other therapies, may be good for the following conditions. However, as with all supplements, patients should consult a healthcare professional prior to taking CoQ10 to assess if it’s suitable for them.
Cardiovascular disease, or CVD. Recent studies indicate that CoQ10 supplements can significantly raise HDL-C and ApoA1 levels, even in individuals taking statins, and may decrease risk for CVD. CoQ10 supplementation reduces levels of inflammatory biomarkers shown to be risk factors for CVD, for example high-sensitivity C-reactive protein. Finally, low CoQ10 levels have been associated with greater tissue damage to the heart during a heart attack and also the brain during stroke.
Statin-related muscle symptoms. Though statin therapy can significantly reduce heart attack and stroke risk, up to 25 percent of individuals quit treatment within six months as a result of unwanted effects, such as muscular aches and weakness. In a 2014 randomized clinical research published in Medical Science Monitor, 75 percent of statin users with muscular symptoms reported reduced pain after taking CoQ10 twice daily for 30 days, compared to zero progress in the placebo group. The researchers reasoned that combining statin treatment with Coenzyme Q10 supplements could cause greater compliance with treatment.
Heart failure, abbreviated as HF. CoQ10 was hailed as “the first new medication to improve heart failure mortality in over a decade” after a multi-center randomized study of 420 patients discovered that taking it reduced deaths in patients with acute HF by half, in comparison to a control group. The researchers tracked the patients for two years. The analysis was presented in the Heart Failure 2013 congress in Lisbon and later published in Journal of the American College of Cardiology Heart Failure.
After a heart attack. In a randomized clinical trial, patients that received CoQ10 soon after a heart attack had a much lower rate of subsequent cardiac events during the next year than a control group (24.6 percent versus 45 percent). About half the patients in both groups were also taking a statin drug, prompting the researchers to report that, “therapy with Coenzyme Q10 in patients with recent heart attacks could be beneficial in patients with higher risk of atherothrombosis, despite optimum lipid lowering treatment.”
High blood pressure. In a study of 12 clinical studies, researchers noted that CoQ10 has the potential to lower systolic blood pressure (the top number in a blood pressure reading) by up to 17 millimeter Hg and diastolic pressure by 10 mm Hg without significant side effects.
Additional Clinical Research
Coenzyme Q10 has persistent and significant antihypertensive consequences in patients with hypertension. The literature is outlined below: (1) Compared to normotensive patients, essential hypertensive patients have a greater incidence (6 fold) of Coenzyme Q10 deficiency recorded by serum levels; (2) Doses of 120 to 225 mg/d of CoQ10, depending upon the delivery procedure or the concomitant ingestion with a greasy meal, are essential to reach a therapeutic level of 3 ug/mL. This dose is generally 3 to 5 mg/kg every day of coenzyme Q10. Oral dosing levels may become lower with nanoparticle and emulsion delivery methods meant to facilitate absorption. Adverse effects have not been characterized in the literature; (3) Patients with the cheapest Coenzyme Q10 serum levels might have the best antihypertensive response to supplementation; (4) The ordinary reduction in BP is roughly 15/10 mmHg and heart rate drops 5 beats/min based on reported studies and meta-analysis; (5) The antihypertensive effect takes time to achieve its peak level at 4 weeks. Then the blood pressure, or BP stays stable during long-term treatment. The antihypertensive effect is gone over two weeks following discontinuation of all CoQ10. The reduction in BP and SVR are connected using the pretreatment and post treatment serum levels of CoQ10. About 50 percent of patients respond to oral CoQ10 supplementation for BP; (6) Approximately 50 percent of patients on antihypertensive drugs may be able to stop between one and three agents. Both entire dose and frequency of administration could be reduced. (7) Doctors administered Coenzyme Q10 with enalapril enhanced the 24 hour ABM better compared to enalapril mono-therapy and also normalized endothelial function; also (8) CoQ10 is a lipid phase antioxidant and free radical scavenger, raises eNOS and NO, reduces inflammation and NF-?B and enhances endothelial func-tion and vascular elasticity.
Other positive effects on cardiovascular risk factors include improvement in the serum lipid profile and carbohydrate metabolism with reduced glucose and enhanced insulin sensitivity, decreased oxidative stress, re-duced heartbeat, enhanced myocardial LV function and oxygen reduction and decreased catecholamine levels.�Although these results have been displayed in several research studies, it’s essential to consult a healthcare professional to discuss your options. The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
By Dr. Alex Jimenez
Additional Topics: Wellness
Overall health and wellness are essential towards maintaining the proper mental and physical balance in the body. From eating a balanced nutrition as well as exercising and participating in physical activities, to sleeping a healthy amount of time on a regular basis, following the best health and wellness tips can ultimately help maintain overall well-being. Eating plenty of fruits and vegetables can go a long way towards helping people become healthy.
Sesame seeds are among the most ancient foods in the world. In fact, sesame plants are the earliest known plant species to be produced mostly for their seeds (pods) and oils instead of for their leaves, fruit or vegetables. Highly appreciated in Asian, African and Mediterranean cultures, sesame seeds (Sesamum indicum) have been used for centuries to flavor foods as well as to provide essential fats and improve skin health.
What is the significance of sesame seeds towards health?
Sesame has among the highest oil contents of any seed along with a rich, nutty flavor. These flexible seeds have long been used by different civilizations around the world, but many people are unaware of their healthy qualities. Evidence demonstrates the benefits of these very small seeds in helping manage common health issues, such as cardiovascular disease, which gives us a lot of reasons to incorporate them into our everyday diet.
Sesame Seed Nutrition Facts
Sesame seeds come out of a flowering plant from the genus Sesamum. Sesame seed pods burst open when they reach full maturity. The actual seeds of the sesame plant are utilized to extract the valuable oils. Sesame seeds contain up to 55 percent oil and 20 percent protein, making them a rich supply of both essential fatty acids and certain amino acids. The seeds contain approximately 50 percent to 60 percent of a fatty oil that’s characterized by two positive members of the lignan family: sesamin and sesamolin. Sesame oil also contains two additional phenolic compounds, sesamol and sesaminol, that are formed through the refining procedure. Oil derived from polyunsaturated is high in linoleic and oleic acids, the vast majority of that are gamma-tocopherol, in addition to other isomers of vitamin. Sesame proteins (amino acids) include lysine, tryptophan and methionine.
One tablespoon of sesame seeds contains approximately:
52 calories
4 grams fat
1 gram carbs
2 grams of protein
4 milligrams copper (18 percent DV)
2 milligrams manganese (11 percent DV)
87 milligrams calcium (9 percent DV)
31 milligrams magnesium (8 percent DV)
3 milligrams iron (7 percent DV)
57 milligrams phosphorus (6 percent DV)
7 milligrams zinc (5 percent DV)
1 milligrams thiamine (5 percent DV)
High Supply of Cholesterol-Lowering Phytosterols
Sesame seeds rank highest in cholesterol-lowering phytosterols from almost all seeds, nuts, legumes and grains. Phytosterols are plant sterols structurally similar to cholesterol that act in the intestine to reduce cholesterol absorption. Phytosterols displace cholesterol inside the gastrointestinal tract, reducing the heart of accessible absorbable cholesterol. Some research has revealed that among 27 distinct nuts and seeds tested, sesame seeds have come out on top (along with wheat germ) as having the highest phytosterol content of them all. They feature approximately 400 grams of phytosterols with each 200 g of seeds. The phytosterol they supply is called beta-sitosterol, which can be tied to improved prostate health and arterial function.
Protect Heart Health
Research shows that lignans help improve lipid profiles and may normalize cholesterol and blood pressure levels. Lignans help naturally lower cholesterol in a couple of ways, they can lower both serum liver and blood cholesterol. Researchers occasionally refer to sesame seed phytochemicals as “hypocholesterolemic agents” for this particular reason. Fifty grams of sesame seed powder taken daily for more than five weeks by healthy adults has revealed favorable effects on total cholesterol, LDL cholesterol, LDL-to-HDL cholesterol ratios and antioxidant status.
In an early study, hypercholesterolemic subjects treated with 32 mg/day of sesamin diminished their levels of total cholesterol and low-density lipoprotein (LDL) following eight weeks, compared to control subjects from whom these levels remained unchanged. In another study, 21 subjects with hypercholesterolemia showed reductions in total cholesterol and LDL by 6.4 percent and 9.5 percent respectively, following the consumption of 40 gram of sesame seeds for four weeks. The decrease in cholesterol vanished, however, once the individuals resumed their normal diet for over four weeks. Sesame ingestion also exerts an antioxidant impact by multiplying the lag phase of LDL oxidation (the stage where oxidation proceeds very slowly).
Recent studies have confirmed these findings. Similar persistent reductions in total cholesterol, LDL, triglycerides, as well as the LDL:HDL ratio are detected when sesame extracts were given to people with elevated blood pressure and also to postmenopausal women. What’s more, in the analysis of hypertensive patients, which contrasted the cholesterol-lowering capability of sesame oil with sunflower and groundnut oils, sesame oil revealed superior antioxidant activity and better protection against lipid peroxidation compared to comparators.
Lipid peroxidation is a harmful free radical-generating procedure which frequently precedes the build up of plaque from the arteries (atherosclerosis). Sesame oil has just been shown to directly inhibit atherosclerosis lesion production, while beneficially altering the lipid profile. It’s believed that one potential mechanism whereby sesame lignans exert their beneficial effects may be by working synergistically with vitamin E in the body to improve blood and tissue levels of this biologically significant antioxidant.
Boost Blood Pressure
Sesame oil is thought to be a powerful antihypertensive as it helps stabilize blood pressure levels. One 2006 study published in The Yale Journal of Biological Medicine investigated the effects of hypertensive adults supplementing with sesame oil daily for 45 days and found that sesame could possibly be a great way to reduce blood pressure. After tracking various health markers of 32 hypertensive patients aged 35 to 60 years that was supplied sesame oil (Idhayam gingelly oil) to utilize it as the only edible oil for 45 days, the investigators discovered that sesame oil helped considerably lower high blood pressure, reduce lipid peroxidation and boost antioxidant status in the majority of individuals.
A recent human study to the effects of various edible oils in hypertensive patients being treated with nifedipine, an anti inflammatory therapy, revealed that sesame oil offered better protection, more than blood pressure, lipid profiles, and lipid peroxidation than either sunflower or groundnut oils. Sesame oil also positively improved both enzymatic and non-enzymatic antioxidants as well as all the other oils.
Other research has shown that the sesame lignans also have a beneficial impact on nitric oxide, a potent vasodilator with anti-atherosclerotic and antithrombotic properties. Dilation of blood vessels makes it a lot easier for blood to flow through, thus lowering the pressure inside the vessels. In one study, sesamol increased the release of nitric oxide in umbilical vein endothelial cells, while another study found that sesamin metabolites enhanced vasorelaxation too. The authors concluded that sesamin’s antihypertensive effects were directly associated with this vessel relaxation.
Further Clinical Research
Sesame was shown to reduce blood pressure at several small randomized, placebo controlled human research within 30 to 60 days. Sesame lowers BP independently or together with nifedipine diuretics and beta blockers. In several 13 mild hypertensive subjects, 60 mg of sesamin for 4 weeks lowered SBP 3.5 mmHg (de < 0.044) and DBP 1.9 mmHg (p < 0.045). Black sesame meal at 2.52 g/d more than 4 weeks in 15 subjects decreased SBP from 8.3 mmHg (p < 0.05) but there was a non-significant decrease in DBP of 4.2 mmHg[259]. Sesame oil in 35 g/d significantly lowered central blood pressure within 1 hour and also claimed blood pressure reduction chronically in 30 hypertensive areas, reduced heart rate, reduced arterial stiffness, decreased augmentation index and pulse wave velocity, decreased HSCRP, improved NO, diminished endothelin-Iand improved antioxidant ability.
In addition sesame lowers serum sugar, HgbAIC and LDL-C, raises HDL, reduces oxidative stress markers and in-creases glutathione, SOD, GPx, CAT, vitamins C, E and A. The active ingredients are organic ACEI’s such as sesamin, sesamolin, sesaminol glucosides, furou-furan lignans which also suppressors of NF-?B. Each of these effects lower inflammation and oxidative stress, improve oxidative defense and reduce blood pressure.
Many clinical research and evidence-based findings have demonstrated the benefits of sesame oil for cardiovascular disease, where the consumption of sesame can protect overall heart health as well as lower cholesterol and boost blood pressure levels. Although these results have been displayed in several research studies, it’s essential to consult a healthcare professional to discuss your options. The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
By Dr. Alex Jimenez
Additional Topics: Wellness
Overall health and wellness are essential towards maintaining the proper mental and physical balance in the body. From eating a balanced nutrition as well as exercising and participating in physical activities, to sleeping a healthy amount of time on a regular basis, following the best health and wellness tips can ultimately help maintain overall well-being. Eating plenty of fruits and vegetables can go a long way towards helping people become healthy.
Cardiovascular disease is the leading cause of death in the United States. According to the Centers for Disease Control and Prevention, CVD results in 611,105 deaths every year. The most common types of cardiovascular diseases include angina, high blood pressure, or hypertension, heart attack, and atherosclerosis. Cardiovascular disease can develop because of a variety of factors, but it’s widely considered that your risk of heart health issues could be significantly affected by lifestyle choices, such as that of an improper diet and nutrition.
How can seaweed contribute to heart health?
Over the past few decades, researchers have indicated that seaweed may have significant effects on cardiovascular disease. Because of its heart health benefits, we ought to be doing more to include these sea vegetables into our diets. Seaweed covers a vast selection of marine macroalgae, which can be categorized into three groups: brown algae (Phaeophyceae), green algae (Chlorophyta) and red algae (Rhodophyta). Many seaweed species possess an assortment of health benefits. They comprise, among other things, beneficial proteins, antioxidants, minerals, trace elements, dietary fiber and polyunsaturated fatty acids. Seaweed is a rich source of proteins known as bioactive peptides. These chemicals have a similar impact to ACE inhibitor drugs and medications, which are prescribed to help lower blood pressure and prevent heart attacks and strokes.
Seaweed and Cardiovascular Disease
Even though there is not any consensual definition for the word “functional food” globally, this is vastly accepted for foods and food components that have been demonstrated to offer certain health benefits beyond the basic nutrition. The design of functional foods is hence undoubtedly associated to the notion of preventing diseases and/or improving optimal health of consumers, besides the simple nourishment requirements.
Seaweed has been a staple ingredient in Asian cultures for centuries. Given the evidence of the beneficial health effects of seaweeds and/or isolates of macroalgae source, there’s a strong case for their inclusion in regular meals (food and beverages), so as to take advantage of their nutrient benefits. It is expected that the joint efforts of business and research in this field will result throughout the forthcoming decades, in a high number of new functional food products reaching to the current market, including those meant to promote heart health.
As per a study review (over 100 research studies), published in the American Chemical Society’s Journal of Agricultural and Food Chemistry, scientists called for “more attempt to exploit the bioactive compounds as well as their potential for utilization and delivery to consumers in food goods. In a study published in the journal Phycologia, researchers suggest that adding seaweed to processed foods may decrease cardiovascular disease. The authors referred their attention to the manufacturers of such foods to fulfill a responsibility for the well-being of their customers.
Clinical Research
Ole G. Mouritsen, a professor of biophysics at the University of Southern Denmark, and colleagues, examined existing knowledge on the health effects of 35 different seaweed species. In the guide, they provide hints to how both individual consumers and the food industry can use seaweed to create everyday healthier meals. By way of instance, dried and granulated seaweed can substitute some of the flour when producing dry pasta, bread, pizza and snack bars, together with as small as a 5 percent replacement needed. Seaweed salt, according to researchers, can also be a healthier salt. Seaweed’s content of potassium salts does not lead to high blood pressure, unlike the sodium salts, typically used in the processed food.
“We all know that many individuals have difficulty distinguishing between healthy and unhealthy food. With the addition of seaweed to processed foods we could produce healthier food. In many cases we also get tastier food, and it may also help reduce the risk of cardiovascular diseases,” the researchers stated. “It is difficult to determine how much seaweed an individual should have to benefit from its great qualities. Five to 10 g of dried seaweed daily is my quote,” states Mouritsen, who has authored several books on seaweed as a healthy food source.
The development of functional foods using seaweeds for boosting heart health have been particularly examined in meat-based products. In these products, it is very important to improve the fatty acid composition and the material of functional ingredients, while decreasing the contents of cholesterol, fat and salt. Different authors have reported that nutritional worth of meat products can be significantly enhanced by the incorporation of whole seaweeds, without hampering quality and sensory properties. Besides, a remarkable work was done by Schultz-Moreira et al., because combined with describing the enhanced nutritional value of restructured meat once augmented with seaweeds, they also assessed different parameters (e.g., lipid profile, antioxidant enzymes and arylesterase) with effect on cardiovascular disease, as demonstrated in hypertensive rats. Additionally, Lim et al. also revealed that chicken and pork patties fortified with Laminaria japonica could improve postprandial plasma glucose and lipids profiles in borderline-hyperlipidemic adults.
For the last decades, development of drinks with seaweeds or extracts has also become the focus of distinct investigations and of many patent registrations. Among those, researchers have patented a beverage containing water-insoluble algal nutritional fibers (0.01% to 20 percent) and citric acid, sugar, fruit juice, plant thickeners and water, which may prevent from distinct diseases, such as cardiovascular diseases. Besides patents, research studies reported the effects of functional drinks. In general, these studies highlighted that beverages made by incorporating macroalgae, particularly using Ecklonia cava, could be of advantage not only because of their minerals and phenolics richness, but also due to their ability to target ACE-I.
Further Clinical Research
Wakame seaweed (Undaria pinnatifida) is the most popular, edible seaweed in Japan. In humans, 3.3 g of dried Wakame for four months significantly reduced both the SBP 14 � 3 mmHg and the DBP 5 � 2 mmHg (p < 0.01). In a study of 62 middle-aged, male subjects with mild hypertension given a potassium-loaded, ion-exchanging, sodium-adsorbing, potassium-releasing seaweed prepara-tion, significant blood pressure reductions occurred at four months on 12 and 24 g/d of the seaweed preparation (p < 0.01). The MAP fell 11.2 mmHg (p < 0.001) in the sodium-sensitive themes and 5.7 mmHg (p < 0.05) in the sodium-insensitive subjects, which connected with PRA.
Seaweed and sea vegetables contain most all of the seawater’s 77I minerals and rare earth elements, fiber and alginate in a colloidal form. The primary effect of Wakame seems to be via its ACEI activity from at least four parent tetrapeptides and possibly their dipeptide and tripeptide metabolites, especially those containing the amino acid sequence Val-Tyr, Ile-Tyr, Phe-Tyr and Ile-Try in certain combination. Its long-term use in Japan has shown its effectiveness. Other varieties of seaweed may reduce BP by decreasing intestinal sodium absorption and raising intestinal potassium absorption.
Conclusion
Seaweeds are a great source of compounds with varied applications, including for heart health and cardiovascular disease, or CVD. This simple fact leaves macroalgae and crude/purified extracts, a possibility of program as ingredients in the formulation of new functional foods in that health field. There’s evidence that diet supplementation with whole macroalgae or products of macroalgae origin can ameliorate several mechanisms underlying the onset and propagation of CVDs. However, we must emphasize that the challenge of working with these components in novel foods should not be restricted to the improvement of the nutritional formulations, but instead, efforts should be done in order to test the promised health benefits of the new products.�The scope of our information is limited to chiropractic and spinal injuries and conditions. To discuss the subject matter, please feel free to ask Dr. Jimenez or contact us at 915-850-0900 .
By Dr. Alex Jimenez
Additional Topics: Wellness
Overall health and wellness are essential towards maintaining the proper mental and physical balance in the body. From eating a balanced nutrition as well as exercising and participating in physical activities, to sleeping a healthy amount of time on a regular basis, following the best health and wellness tips can ultimately help maintain overall well-being. Eating plenty of fruits and vegetables can go a long way towards helping people become healthy.
IFM's Find A Practitioner tool is the largest referral network in Functional Medicine, created to help patients locate Functional Medicine practitioners anywhere in the world. IFM Certified Practitioners are listed first in the search results, given their extensive education in Functional Medicine
Nutritional Strategies: The focus of this paper is to explore better strategies for optimizing bone strength and reducing risk of fracture, while at the same time decreasing risk of cardiovascular disease. The majority of Americans do not consume the current recommended dietary allowance for calcium, and the lifetime risk of osteoporosis is about 50%. However, traditional mono-nutrient calcium supplements may not be ideal. We comprehensively and systematically reviewed the scientific literature in order to determine the optimal dietary nutritional strategies and nutritional supplements for long- term skeletal health and cardiovascular health. To summarize, the following steps may be helpful for building strong bones while maintaining soft and supple arteries: (1) calcium is best obtained from dietary sources rather than supplements; (2) ensure that adequate animal protein intake is coupled with calcium intake of 1000 mg/day; (3) maintain vitamin D levels in the normal range; (4) increase intake of fruits and vegetables to alkalinize the system and promote bone health; (5) concomitantly increase potassium consumption while reducing sodium intake; (6) consider increasing the intake of foods rich in vitamins K1 and K2; (7) consider including bones in the diet; they are a rich source of calcium-hydroxyapatite and many other nutrients needed for building bone.
Most vegetarians, especially vegans, appear to absorb less calcium because of the oxalic and phytic acid contained in many plant, grain and legume products.1 Indeed, several studies have reported that risks of bone fracture are higher in vegans�likely due, at least in part, to their lower dietary calcium intake, and/or poor absorption of this key mineral (table 1).21
Maintaining replete magnesium status may reduce risk for the metabolic syndrome, diabetes, hypertension and MI.30 Circumstantial and experimental evidence has also implicated magnesium deficiency in osteoporosis.31�34 Optimal dietary magnesium intake is about 7�10 mg/ kg/day, preferably in the context of a net base-yielding diet, since a net acid-yielding diet increases excretion of both magnesium and calcium (table 2).
Vitamin K2 intake has been associated with decreased arterial calcium deposition and the ability to reverse vascular calcification in animal models. Vitamin K2 prevents pathological calcification in soft tissues via the carboxylation of protective MGP. The undercarboxylated (inactive) species of MGP is formed during inadequate Vitamin K status, or as a result of Vitamin K�antagonists.42 Low Vitamin K status is associated with increased vascular calcifications, and can be improved by effective Vitamin K supplementation (table 3).43 44 In two different randomized, double-blind controlled trials, supplemental Vitamin K has been shown to significantly delay both the development of coronary artery calcification and the deterioration of arterial elasticity.45 46
adequate calcium intake without predisposing to CVD risk. Ingestion of micro- crystalline hydroxyapatite (the form of calcium found in bone) produces less of an acute spike in blood calcium levels compared to soluble calcium salts typically used in standard supplements, and thus may be less likely to increase vascular calcification and coronary risk.65 Hydroxyapatite also stimulates bone osteoblast cells and contains virtually all the essential building blocks needed to construct bone tissue. In a small placebo- controlled randomized trial, women who took 1000 mg of calcium in the form of hydroxyapatite in conjunction with oral Vitamin D showed a significant increase in bone thickness, whereas those who took 1000 mg of a standard calcium carbonate supplement did not (figure 4).70 Another double-blind placebo-controlled study found�that supplementing with hydroxyapatite and Vitamin D3 significantly improved serological markers of bone health.15
