IMPORTANT NUTRIENTS WE LACK #4: VITAMIN B-12

Vitamin B12 is a nutrient that helps keep the body's nerve and blood cells healthy and helps make DNA, the genetic material in all cells. Vitamin B12 is also very important in the body's use of folic acid.  Numerous studies suggest low B12 status contributes to cognitive decline and memory problems in the elderly. 

It is believed that as much as 40% of persons over 50 in the US have insufficient or deficient levels of B12.  B12, found in all animal-based foods including meat, fish, poultry, dairy, and eggs, is plentiful in the American diet, but people who are elderly and/or taking medicines for acid reflux are at risk for low vitamin B12 because of inadequate digestion of the nutrient.  Two steps are required for the body to absorb vitamin B12 from food. First, hydrochloric acid in the stomach separates vitamin B12 from the food proteins.  Next, vitamin B12 combines with a substance made by the stomach called intrinsic factor. Only then can it be absorbed by the body.   So, persons with reduced stomach acid have compromised B12 absorption.

Some researchers theorize that one of the ways low B12 contributes to cognitive problems is that B12 is required to metabolize supplemental folic acid.  The US wheat supply has been fortified with folic acid since 1998 so intake of the vitamin is often quite high.  Without adequate vitamin B12 to process supplemental folic acid, it is believed that the unmetabolized folic acid may be depositing on neural tissue and contributing to mental declines.

What to do:  The most common bloodwork tests of B12 levels are known to be quite inaccurate as B12 is stored in the liver.  If you take medicine for acid reflux, the diabetes drug Metformin, or are over 50 discuss taking a supplement with your healthcare provider.  The supplemental form is easily absorbed regardless of your stomach acid production.  If supplementing, choose one that dissolves under the tongue.

IMPORTANT NUTRIENTS WE LACK #3: MAGNESIUM

Every organ in the body -- especially the heart, muscles, kidneys, pancreas, and bones -- needs the mineral magnesium. Many large observational studies have found that low magnesium intake is linked to higher rates of type 2 diabetes.  While excess weight is by far the most important risk factor for type 2 diabetes, inadequate magnesium appears to also be a contributing factor.  For example, two landmark studies in the US that tracked over 127,000 people for up to 18 years found that those with higher magnesium intake were 27% less likely to get diabetes than those with lower magnesium intake.  Higher magnesium intake has also been linked to lower levels of inflammation in the body and this may be one way that it reduces risk of type 2 diabetes.

What to do:  It is recommended that women get 320mg of magnesium and men get 450mg.  Most Americans are falling short.  The best dietary sources of magnesium include seeds, nuts, dark greens, beans, bran, and fish.  Be sure to check with your health care provider before taking magnesium supplements.  The most absorbable forms are magnesium citrate, magnesium gluconate, and magnesium lactate.

IMPORTANT NUTRIENTS WE LACK #2: VITAMIN D

Studies suggest adequate levels of vitamin D are important not only in maintaining healthy bones but also in reducing the risk for cancer, heart disease, stroke, diabetes, hypothyroid, and autoimmune diseases.  Vitamin D is actually a hormone that the body produces when exposed to the sun.  Persons who are older, obese, and/or have darker skin have less capacity to make vitamin D.  Also, those living in colder climates such as New York have reduced exposure to the sunlight.   And too much sun exposure can also be risky as it increases skin cancer rates.  An estimated 40%-75% of Americans have insufficient vitamin D levels.   

Low vitamin D levels are linked to a number of risk factors for cardiovascular. It is believed Vitamin D reduces blood vessel inflammation and therefore is an important ingredient in the prevention of heart disease.  A recent review of 75 research studies on Vitamin D and heart disease concluded there is evidence low vitamin D levels are associated with unhealthy blood pressure, insulin resistance, and coronary artery disease. 

What to do:  Next time you get blood work, request that your doctor check your vitamin D level.  This way you can know if you are deficient or not and how much to supplement with.  Food sources of vitamin D include fortified products such as milk, fish with bones such as sardines, and fish liver oils.  If supplementing, be sure to choose vitamin D3 , not vitamin D2 which is less well used by the body.  

IMPORTANT NUTRIENTS WE LACK #1: POTASSIUM

Potassium is a key mineral that helps to counterbalance the effects of sodium on blood pressure.  Adequate intake has also been linked to better bone health and reduced rates of kidney stones.  However, it is estimated that 90% of American men and 99% of American women do not consume the recommended 4,700 mg per day. 

One out of every four Americans has high blood pressure. Certainly, lifestyle changes such as being physically active, quitting smoking, moderating alcohol intake, and losing excess weight help to control blood pressure.  Diet composition also has a significant effect on blood pressure.  Most people know to focus on lowering sodium intake, but do not realize that increasing potassium is also very important.  There are many large observational studies indicating low potassium intake is associated with higher blood pressure and increased rates of strokes and heart attacks.  It is believed potassium lowers blood pressure by increasing the elasticity of large blood vessels like the aorta and carotid and dilating small blood vessels. 

The best dietary sources of potassium are fresh fruits and vegetables.  In plant foods, potassium usually occurs in the form of potassium citrate and it is now being recognized that the citrate is also helpful in lowering blood pressure.  It is the citrate that helps to reduce kidney stones by binding to calcium that otherwise are able to bind to oxalates producing calcium oxalate stones.   It is also believed that the citrate in potassium citrate contributes to bone health by reducing urinary calcium losses. 

What to do:  Taking potassium supplements can be dangerous for persons with kidney disease or those taking blood pressure medicines that prevent potassium excretion.  Only supplement if advised to do so by a physician.  The best way to increase potassium intake is to consume a diet rich in fresh fruits and vegetables (especially good options are dark greens, yams, winter squash, bananas, kiwis, cantaloupe, papaya, avocados, and citrus), dairy, beans, and whole grains.  

Minimizing Your Exposure to Acrylamide, the Carcinogen Produced When Starches Are Toasted or Fried

Acrylamide is found in foods that make up 40% of calories in a typical American diet.  Acrylamide is generated when potatoes, grains, coffee beans, and other starchy foods are browned through frying, baking, toasting, or roasting. That means it shows up in fries, chips, breakfast cereals, toasted bread, cookies, crackers and even coffee.  Acrylamide is of concern because it appears to increase one's risk of cancer.

What to do:  It is impossible to completely eliminate acrylamide from your diet but you can reduce your exposure by reducing your intake of high acrylamide foods and modifying how you prepare starchy foods. In general the browner or crispier a starch, the more acrylamide.  Here's some tips to reduce your intake of acrylamide. 

• Try not to fry.  Frying causes the most acrylamide formation.  For example, there's little or no acrylamide in boiled or microwaved potatoes. The next best method is baking them whole, followed by roasting pieces.  Instead of frying foods opt for steaming or boiling foods.  These are moist low heat methods of cooking that do not significantly increase acrylamide levels.
• Toast lightly.  Toast bread to a light brown color rather than a dark brown color. Avoid or remove very brown areas.  Also try to avoid charred grains such as blackened pizza crust or burnt outer edges of grain based items. 
• Do not store potatoes in the refrigerator.  This increases acrylamide formation during cooking. Keep potatoes outside the refrigerator in a dark, cool place, such as a closet or  pantry.  Also, soaking potatoes before cooking them removes some of the starches that form acrylamide.
• Follow a heart healthy diet moderate in starchy carbohydrates.  Emphasize fresh and frozen fruits and vegetables, lean proteins and low-fat dairy products, healthy oils, and whole grains prepared with moist heat.   
• Do not overdo the coffee.  Acrylamide forms when the beans are roasted, not when the coffee is brewed, so there's not much you can do to reduce the acrylamide in coffee. Surprisingly, robusta and light roast beans have somewhat higher levels than arabica and dark roast beans.

Adapted from articles available at:

http://www.usatoday.com/story/news/nation/2013/11/23/french-fries-acrylamide-fda/3642183/

http://www.fda.gov/Food/NewsEvents/ConstituentUpdates/ucm374601.htm

http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm374855.htm

http://www.fda.gov/Food/FoodborneIllnessContaminants/ChemicalContaminants/ucm053569.htm

DIETS RICH IN FRUITS REDUCE RISK OF LETHAL ANEURYSM

A large long-term Swedish study has found that eating lots of fruit might decrease your risk of developing a dangerous bulge in the wall of the body’s largest artery, the aorta.  This condition is known as an abdominal aortic aneurysm and can result in death if the bulging artery bursts.   

In this study, researchers analyzed dietary and lifestyle data from more than 80,000 people, age 46 to 84.  They tracked the individuals for 13 years.  During that time, nearly 1,100 of the participants had abdominal aortic aneurysms, including 222 whose aneurysms ruptured.

Those who ate the most fruit had the greatest reduction in aneurysm rates.  After controlling for other lifestyle factors known to impact vascular disease risk, researchers found that those who ate more than two servings of fruit a day (not counting juice) had a 25% lower risk of the condition and a 43% lower risk of rupture than those who ate less than one serving of fruit a day. 

This study adds to the consensus that diets rich in fruits and vegetables help to reduce risk for vascular diseases including high blood pressure and clogged arteries.  One reason that fruits promote vascular health is because they contain high levels of antioxidants which reduce inflammation in the body.  Most fruits are also rich in potassium and diets rich in potassium are also know to be good for blood pressure.   

What to do:  Regularly include a variety of fruits in your diet, at least 2 per day.  The American Heart Association recommends 4-5 servings of fruit a day.  Besides a plant rich diet other factors that reduce your risk for aortic aneurysms include not smoking, maintaining a healthy weight, and controlling blood pressure and cholesterol.  Aortic aneurysms often have no symptoms but can be easily detected with an abdominal ultrasound and treated when necessary.  Discuss with your provider whether you might need an abdominal aortic screen.

Adapted from articles available at:

http://newsroom.heart.org/news/eating-more-fruit-may-lower-your-risk-of-lethal-aneurysm

http://www.nlm.nih.gov/medlineplus/news/fullstory_139874.html

Source:

Stackelberg O, Björck M, Larsson SC et al.  Fruit and vegetable consumption with risk of abdominal aortic aneurysm.  Circulation 2013; 128: 795-802.  Available at: http://circ.ahajournals.org/content/128/8/795

SKIPPING BREAKFAST MAY RAISE DIABETES RISK

Eating breakfast every day may help reduce the risk of weight gain and developing diabetes.  A small new study of overweight and obese women found that when participants skipped breakfast, their blood glucose and insulin responses to the same lunch meal increased. 

In the study, Dr. Elizabeth Thomas and her team at the University of Colorado measured the levels of participants’ insulin and blood sugar on different days after the women ate the same lunch. On some of the days, researchers gave the participants breakfast while on other days participants did not eat breakfast.  Glucose levels normally rise after eating a meal, and that in turn triggers insulin production, which helps the body’s cells take in the glucose to use for energy.  When the cells respond to the insulin, blood sugar drops back down.  The researchers found that on days when the women had not eaten breakfast, blood sugar responses to the same lunch meals rose 12% higher and the insulin their bodies’ produced in order to get the cells to take up the glucose rose 28%. 

The fact that the women's insulin and glucose levels after lunch were significantly higher on the days they skipped breakfast than on the days they ate it, means that the cells of the body were less receptive to taking up fuel when breakfast had been skipped.  As a result, glucose levels remained higher and the pancreas had to produce more insulin in order to get the cells to take up the glucose.  When cells become progressively resistant to responding to insulin, type 2 diabetes develops.  While in this study, the higher glucose and insulin levels following lunch were a short-term effect, it is possible that, over time, this meal pattern increases rates of diabetes.  Another drawback to excess insulin production is that having greater levels of insulin in body generally leads to more nutrients being directed to fat storage, increasing the likelihood of weight gain.  Excess insulin can also lead to increased carbohydrate cravings, which can also lead to weight gain. 

What to do: Eat a healthy breakfast!  Aim to include fiber rich whole grains, fruits and/or veggies and some lean protein such as nonfat dairy or eggwhites and limit the amount of unhealthy fats such as those from meat, butter, and cream.  No time?  Some easy on the run options - add a fruit to any of the following:  whole-grain toast/English muffin with peanut butter/lowfat cheese/turkey; a cup of nonfat Greek yogurt with a handful of whole grain cereal; a baggie of dry cereal and nuts; a hard-boiled egg & whole-grain crackers.

Source:

Thomas, E.  June 16, 2013, presentation, Endocrine Society annual meeting, San Francisco, CA.

Adapted from article available at:  http://www.nlm.nih.gov/medlineplus/news/fullstory_137866.html