Calcium-Part 2: Where can I get my Calcium?

Examples of high-protein foods are tofu, dairy...

Examples of high-protein foods are tofu, dairy products, fish, and meat. (Photo credit: Wikipedia)

Food sources of Calcium

I have included a table of the amounts of calcium in different food types. This is a very general representation.  A more complete list can be found on the US Department of Agriculture’s Nutrient Database.

  • dairy products (milk, yogurt and cheese): this is difficult for lactose intolerant or lactose sensitive people. Some people may be concerned about the non-organic dairy products due to antibiotics injected into animals etc.
  • vegetables: chinese cabbage, kale and broccoli. These vegetables also have vitamin K2 and D which are also required for calcium absorption
  • Spinach: its bioavailability is poor[i]
  • Calcium fortified juice/grain/cereal
    Selected Food Sources of Calcium[ii]
    Food-Dairy Products mg per serving
    Yogurt, fruit-plain, low fat, 8 ounces

    338-415

    Chedder and Mozzarella (part skim)1.5 ounces

    307-333

    Milk (nonfat/2%/whole) 8 oz

    276-299

    Frozen yogurt(Vanilla:1/2cup), Cottage cheese(1% milk fat, 1 cup)

    103-138

    Cheese, cream, regular, 1 tablespoon

    14

    Sour cream, reduced fat, cultured, 2 tablespoons

    31

    Food-Fortified Products
    Orange juice, calcium-fortified, 6 ounces

    375

    Instant breakfast drink, various flavors and brands, powder prepared with water, 8 ounces

    105–250

    Ready-to-eat cereal, calcium-fortified, 1 cup

    100–1,000

    Food-Fish
    Sardines, canned in oil, with bones, 3 ounces

    325

    Salmon, pink, canned, solids with bone, 3 ounces

    181

    Food-Soy
    Soy beverage, calcium fortified, 8 ounces             80–500
    Tofu, firm, made with calcium sulfate, ½ cup*

    253

    Tofu, soft, made with calcium sulfate, ½ cup*

    138

    Food-Grain
    Bread, white, 1 slice

    73

    Bread, whole-wheat, 1 slice

    30

    Tortilla, corn, ready-to-bake/fry, one 6″ diameter

    46

    Tortilla, flour, ready-to-bake/fry, one 6″ diameter

    32

    Food-Vegetables
    Turnip greens, fresh, boiled, ½ cup

    99

    Kale, fresh, cooked, 1 cup

    94

    Kale, raw, chopped, 1 cup

    90

    Chinese cabbage, bok choi, raw, shredded, 1 cup

    74

    Broccoli, raw, ½ cup

    21

    Food-Others
    Pudding, chocolate, ready to eat, refrigerated, 4 ounces

    55

    Foods providing 20% or more of the DV (Daily Value) are considered to be high sources of a nutrient, but foods providing lower percentages of the DV also contribute to a healthy diet. Calcium content varies slightly by fat content; the more fat, the less calcium the food contains.
    * Calcium content is for tofu processed with a calcium salt. Tofu processed with other salts does not provide significant amounts of calcium.

    References:

    [i] http://ods.od.nih.gov/factsheets/Calcium-HealthProfessional/

    [ii] U.S. Department of Agriculture, Agricultural Research Service. 2011. USDA National Nutrient Database for Standard Reference, Release 24. Nutrient Data Laboratory Home Page, http://www.ars.usda.gov/ba/bhnrc/ndl.

Posted in Bone Health | Tagged , , , , , , , | 3 Comments

Weight Loss Myth 3: “I can’t lose weight! It’s my genes.”

English: DNA Double Helix

English: DNA Double Helix (Photo credit: Wikipedia)

I see many patients who complain of joint pain, diabetes, weight problems and other medical conditions. Some of them are legitimate genetic or congenital issues. Many also blame “family genes.” Although I don’t deny that genetics play a part, but there is more to it.

“We may not be able to change our genetics; however, we can influence the expression of the genes with our lifestyles/environment.” Dr. Mary-Ellen Kelly ND.

Sometimes, it may not be genetics at all. It is simply the habits that are passed on from one generation to the next. How we behave and act has a lot to do with our upbringing, which can influence the way we talk, act and even eat. My grandparents grew up eating rice, as did my parents, my cousins, my brother and myself. Other families grow up eating burgers and french fries for lunch almost every day. Others grow up eating until they are only 75% full after every meal. Other families grow up participating in all kinds of sports. So you see, it is not always “family genes,” it’s more like “family habits.”

If you want to lose weight, commit to a program that focuses on lifestyle changes and educates on nutrition, not just magic supplements, meal replacement, injections or blindly following a meal plan. You can empower yourself in the process by educating yourself. The way you choose to lose weight will also impact how your children will live healthily in the future.

Posted in Nutrition | Tagged , , , , , , | 3 Comments

Zinc Plus Antibiotic Reduces Treatment Failure in Infants

infant

infant (Photo credit: soupboy)

According to a randomized, double-blind study, infants with probable serious bacterial infection who received zinc in addition to standard antibiotic therapy were less likely to suffer treatment failure. The results indicated that zinc supplementation reduced the incidence of treatment failure by 54% and zinc had a greater effect in infants with diarrhea than in those without diarrhea. However, the researchers caution that additional research is necessary before zinc can be applied clinically to prevent treatment failure. (see full article)

If you are wondering whether zinc supplement is appropriate for your child, please consult with your physician and your naturopathic doctors.

Reference: Medscape News Today

Posted in Pediatrics | Tagged , , , , , , , , | Leave a comment

Calcium-Part 1: What kind should I take? I am confused!!!!

English: An osteoporotic elderly women in Japan.

English: An osteoporotic elderly women in Japan. (Photo credit: Wikipedia)

There are hundreds of different brands of calcium supplements and different forms of calcium.  When we are talking about calcium intake, we are actually referring to the elemental calcium, not the compound calcium. What does this mean?

Elemental Calcium vs Calcium Compound

Calcium is absorbed into our body as ionized elemental calcium (Ca 2+). This means that we need to check the amount of elemental calcium the supplement contains rather than just the amount of calcium as a compound (ie calcium carbonate, calcium citrate etc). What is important on the label is the amount of elemental calcium, not just the calcium compound. For example, a calcium compound such as calcium carbonate has 40% of elemental calcium. If the bottle says each serving has 1000mg of calcium carbonate, it may only contains 400mg of elemental calcium.  We can also check the label by looking for the RDA (Recommended Daily Amounts).  If the bottle states a serving contains 40% of the RDA of calcium, then it contains 400mg of elemental calcium per serving (RDA for most individuals is 1000mg of calcium per day). Fortunately, elemental calcium is listed in the Supplement Facts panel, so consumers do not need to calculate the amount of calcium supplied by various forms of calcium supplements.

Different types of Calcium

Calcium may exist in different forms, each form may contain different amounts of elemental calcium.  The two main forms of calcium in supplements are calcium carbonate and calcium citrate.

Calcium Compound Description
Calcium carbonate(Ca2+: about 40% calcium by weight[i])
  • most inexpensive, common and convenient
  • it’s absorption depends on stomach acid.
  • best if taken with food
  • cause more gassing, bloating, constipation (if this occurs, need to spreading out the calcium dose throughout the day and/or taking the supplement with meals)
  • study indicates that chronic use of Calcium carbonate only supplement may decrease stomach acidity over time.
  • may not be tolerated well in people with a history of stomach ulcer [ii]
alcium citrate(Ca2+: about 20% by weight)
  • more soluble, therefore excellent absorption
  • absorbed well even without food
  • great for people with achlorhydria, bowel disease or absorption disorders. [iii]
Calcium lactate(Ca2+: about 13% by weight)
  • highly soluble calcium salt and bioavailable. It is used in calcium fortification of beverages. [iv]
  • can be effective at various pHs

Other types of calcium supplements:

Oyster Shell Calcium: Due to environment pollution, some oyster shell calcium may contain lead. It’s up to the manufacture to strip away the lead from the oyster shell calcium as much as possible.

Ionized form: liquid or powder which can be dissolved in liquid is ideal.

References:

[i] http://orthopedics.about.com/od/osteoporosistreatment/f/calciumtype.htm

[ii] http://www.health.harvard.edu/newsweek/What_you_need_to_know_about_calcium.htm

[iii] Committee to Review Dietary Reference Intakes for Vitamin D and Calcium, Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Calcium and Vitamin D. Washington, DC: National Academy Press, 2010.

Posted in Bone Health | Tagged , , , , , , , , , | 4 Comments

Live It up and celebrate Senior’s Month this June

Guest blog courtesy of Jackie Hickey, RN CCP, Community Health Advisor Bayshore Home Health.

This June we commemorate the twenty-eighth year of Seniors’ Month in Ontario, a month to celebrate, honour and recognize the distinctiveness and magnificence of our oldest generation.

Have you ever sat down and really listened to a senior tell their story? As a new grad fresh out of nursing school in the mid ‘80s, my first job was on a medical floor at St. Joseph’s Hospital in Toronto. My fondest memory was the night shift (yes, I said night shift). I would sit for hours listening to our oldest patients engage in conversation about the “olden days,” tell their personal stories and enjoy the camaraderie they felt so fortunate to have, as many of their families and friends were no longer alive.

Seniors at an educational program

Seniors at an educational program (Photo credit: Wikipedia)

It fascinated me to hear about the many “firsts” that occurred in their generation – motorized cars driving on the road, inventions that we take for granted and the world wars. On many occasions I laughed, on some I cried and I felt the longing these folks had for a bygone time. I learned firsthand about the wonders and growth our society has had over the last 100 years. I guess that’s why I love a good story that anyone has to tell. This privileged experience also taught me that life is not easy and to appreciate every day and everyone, for one day life could suddenly change.

This year’s theme is Celebrate, Participate, which emphasizes the importance of recognizing the pillars of our community and staying active. Many communities are jumping on the age-friendly healthy lifestyle bandwagon in support of our aging population.

As our population ages, we are slowly realizing the need to savour our golden generation in more ways then one. The Ontario government is working hard to help create healthy and accessible communities by protecting seniors and encouraging age-friendly communities – it’s time we recognize and improve the quality of life for our seniors.

One only has to look around, to see the many contributions our seniors – older adults, elders – have made. Being politically correct may not really matter to seniors, but recognizing their efforts in building a sustainable society for generations to come does.

Our seniors are the very foundation of society and the strength of our community. From the torment of the Great Depression to the anguish of post-world wars, they carried on and rebuilt families, communities, economic stability and hope. They also contributed to their own longevity through good nutrition, healthy lifestyles and medical advances. But most significantly, they maintained peace so that their children and future generations would be safe and prosperous.

The next time you need to remember something of importance that happened many years ago, ask a trusted senior. They would likely give you a good answer and a fascinating

anecdote to go along with it. Spend some quality time with a senior near and dear to your heart – you may laugh, you may cry but it’s certain you will make their day … and it also might make yours!

As a Registered Nurse and Community Health Advisor with Bayshore Home Health, I have a strong goal to educate and support family caregivers in caring for their loved ones, and serve as a trusted health advisor. I strive to make a difference in the future health of aging Canadians. For more information, please contact me at 416-992-4280 or jhickey@bayshore.ca or visit the Caring@Home blog at

www.bayshore.ca/caringathomeblog

Posted in Uncategorized | Tagged , | Leave a comment

“i” syndrome. What is it?

Texting on a qwerty keypad phone

Texting on a qwerty keypad phone (Photo credit: Wikipedia)

Everywhere you look, people are walking with their heads down and thumbs are busy using their ipad, ipod, iphone other similar devices. This is happening at work, school, home, in the car (as a passenger hopefully) and on the street. You would see people literally walk into a pole while using their devices. Many articles cite the potential health risks posed to our body from repetitive use of these new electronic devices. Most of them discuss one or two areas of concern. This article is to draw your attention to the overall health risk these devices pose from overuse. It seems that it affects the younger generation the most. I coin these collective health concerns as “i” syndrome.

“i” syndrome consists of the following symptoms:

1) pain in the neck / upper back (Text Neck): Neck and shoulder pain related to texting or use of smart phones is caused by the poor posture of prolonged flexion of the neck. The symptoms may include the following:

  • neck and upper back/shoulder pain initially
  • symptoms may progress to include numbness and tingling in the arms/fingers due to compression of the nerves around the neck area.

Judith Gold, an ergonomics researcher at Temple University in Philadelphia, presented a preliminary research on approximately 140 college students on the relationship between texting and repetitive strain injuries. The study found a correlation between the amount time a student spent texting and how severe their neck and shoulder pain was[1]

2) symptoms in the thumbs/wrists: This is popularly termed “blackberry thumb” or “teen texting tendonitis”.  Our thumb is designed for pinching and gripping things. They simply weren’t designed for repetitive texting at a speed of 72 letters per minute. It is estimated that teenagers sending and receiving an average of 80 text messages each day may be vulnerable to repetitive stress injuries of the thumb[2]. It has also been documented that over 38% of the general population suffer from sore wrists and thumbs from texting[3].

  • pain and numbness at the base of the thumbs or fingers or joints of the hand
  • pain in elbow
  • tired, achy fingers and cramping
  • decrease joint mobility

3) decrease in communication skills (verbal and writing): While the advance of telecommunication technologies allow us to keep in touch with each other easily. Many employers are now finding that the biggest challenge among college graduates is an inability to speak and write effectively.

  • 64% of the teens inadvertently use improper grammar or punctuation, carrying over texting habits to other forms of writing[4]
  • 25% have used emoticons in their school writing; 38% have used text shortcuts such as “LOL” meaning “laugh out loud”.  And these ‘shortcuts’ are showing up on the job!

4) Sleep problems: Many teenagers and young adults text or surf the internet at bedtimes. A pilot study in 2010 showed that texting, emailing and other electronic devices are causing an epidemic of sleep deprivation among high school and college students[5]. We know how important sleep is. Lack of sleep affects our overall health in many ways including our immune system. The problem is not only sleep deprivation, but includes mood, behaviour and cognitive problems during the day. The study showed the following:

  • 77.5% of participants of the study had persistent problems falling asleep.
  • On average, a participant sent 33.5 emails or texts per night during sleeping hours
  • Among the adolescent participants, the older they were, the more time they spent with their electronic devices at bedtime.

5) Compulsive texting: We see people who text at all hours and in all places. Some people seem to have developed behaviour that is similar to addiction. A study in 2010 by Paul Atchley,   an associate professor of psychology at Kansan University, that surveyed 400 college students ages 18-30 showed texting while driving is more dangerous than drunk driving[6]. The study found that 95 % of the students were likely to either initiate or respond to a text message while driving. The surprising find from the study indicates the people who do text and drive are generally aware of how risky the behavior is, yet they do it anyway. Atchley compared their mindset to those who are addicted to nicotine. Some scientists have even compared it to driving under the influence.

6) Eye strain (or “i” strain): There are debates over what type of reading screen is better: LCD or e-lnk. However, “it’s a variety of other factors that can cause physical fatigue.” said Dr. Travis Meredith, chair of the ophthalmology department at the University of North Carolina. The ergonomics of reading screens and the lack of blinking when we stare at them play a big role in eye fatigue.[7]

E Ink has a very low contrast ratio. Although it can offer an excellent reading experience in bright sunlight, the screens can become uncomfortable to use in dark settings because of the lack of contrast and backlighting on the screen.

Apple’s latest IPS LCD screens include extremely wide viewing angles, but the reflective glass on the screen could be a hindrance in brightly lit situations. At the of the day, it depends on your reading need and how comfortable you feel.

Advise: 20/20/20 role: every 20 minutes look 20 feet away for 20 seconds to allow your eyes to refocus.

Consider the following facts about texting

  • 1/3 of teens send more than 100 text messages daily
  • Of the 83% of American adults who own cell phones, roughly 73% of them send text messages and about 31% of them prefer texting to actually talking on the phone.[8]
  • Average texting speed of a 14 year old girl is 72 letters per minutes.
  • The number of text messages sent on cell phones has more than doubled from 48 billion in December 2007 to 110 billion in December 2008[9]
  • 18 to 24 year olds average 110 text messages per day[10]

References:

  1. http://www.webmd.com/pain-management/news/20091112/texting-can-be-a-pain-in-the-neck-shoulders/
  2. http://solomonsseal.wordpress.com/2010/02/12/healing-texting-thumb-and-repetitive-stress-injuries-rsi-with-solomon%E2%80%99s-seal/
  3. http://www.diversifiedhealth.ca/sports-therapy/thumb-pain-text-message-injuries-are-increasing-says-a-vancouver-island-health-clinic/
  4. http://priscilla-tovey.suite101.com/communication-skills-lacking-in-college-grads–is-texting-to-bla-a257133
  5. http://www.medicalnewstoday.com/articles/206546.php
  6. http://www.kansan.com/news/2010/apr/23/texting-and-social-skills/
  7. http://bits.blogs.nytimes.com/2010/02/12/do-e-readers-cause-eye-strain/
  8. http://pewinternet.org/Reports/2011/Cell-Phone-Texting-2011.aspx
  9. http://hothardware.com/News/US-Texting-Rate-More-Than-Doubles-In-A-Year-My-Thumz-Hrt/
  10. http://www.pewinternet.org/~/media/Files/Reports/2010/PIP-Teens-and-Mobile-2010.pdf
  11. http://bits.blogs.nytimes.com/2010/02/12/do-e-readers-cause-eye-strain/

 

Posted in General Health | Tagged , , , , , , , , , , , , , | 1 Comment

Weight Loss Myth #2: low carb diet

As well as calorie restriction diet, low carb diet is also very common. Atkins is a popular low carb diet which promotes high protein and fat. It is effective with weight loss; however, the long-term health benefits are highly controversial.

How does Atkins work?

low carb

low carb (Photo credit: daBinsi)

The principle of Atkins is based on converting the body from carbohydrate burning to fat burning for fuel, then slowly reintroducing complex carbohydrates back into the diet during weight maintenance.

Our body normally uses carbohydrates as primary fuel for energy. Generally speaking, fat is stored as a backup or reserve fuel for energy. That’s how our body compensates during a famine or starvation environment. By drastically reducing carbs from our diet and eating more protein and fat, our body is forced to burn fat for energy in order to maintain our daily activity level. This results in weight loss. When we start to burn fat as a primary source of fuel over a long period of time, our body goes into a state of ketosis, which means it burns its own fat for fuel. Ketosis can cause a variety of side effects such as bad breath and constipation.

Long term benefits?

Although there are studies which show that this form of diet is successful in weight loss, the long term health benefit remains controversial in the U.S. and abroad. The concern for low carb/high protein/high fat diet go way beyond the question of whether it is effective for weight loss or keeping the weight off. Many experts are concerned about the long term use of this form of diet with regard to bone health, cancer, and in people with liver/kidney problems. In addition, a low carb diet is not practical for long term in many cultures.

Again, our body is designed to burn carbs as a primary fuel for energy over thousands of years of evolution. Fat as energy fuel is meant as a secondary energy source, not primary energy source. This is not what the body is designed to do. Gail Frank, PhD, former spokeswoman for The American Dietetic Association and professor of nutrition at California State University in Long Beach, says, “When our body get less than our minimum carbohydrates (about 150 grams daily), normal metabolic activity is disrupted.”

Posted in Nutrition | Tagged , , , , , , , , , , , | 5 Comments

Weight Loss Myth #1: Calorie restriction does not work!

Tteokbokki with sticky noodle

Tteokbokki with sticky noodle (Photo credit: Wikipedia)

1) We need a minimum amount of calories per day to function. The minimum calories needed depends on age, gender, body size and activity level. It ranges from 1400 cal to 3500 cal per day. Some diet or exercise experts may suggest 500 fewer calories per day than your daily caloric needs for weight loss. However, the first thing you would notice is lack of energy. Calorie restriction may result in rapid weight loss in a short period of time for some people, however, it typically scarifies lean muscle loss and water loss. This is not a healthy weight loss!

2) Calorie restriction may not work for some because your body is always in a fat storage mode. So it does not matter how little you eat, your body will always want to store the food as fat. Have you noticed that some people seem to eat a lot and do not gain weight? Some people eat very little and do not seem to lose weight?

3) It is impractical to count your calories for every meal and for a long period of time. Obviously, you don’t want to overeat and with little activity as well, this is just common sense.

4) Studies show that dieting as the only mode of behavioral modification in weight management has proven to have little long-term success with a >80% failure rate. It can also result in elevated weight regain and increased risk for diabetes and related metabolic disease after dieting.

5) When you focus on a low-calorie diet you slow down the body’s metabolism.  When your body’s metabolism slows down, it becomes more difficult to lose the unwanted pounds. If you want to lose weight, you need to increase your metabolism,  NOT DECREASE IT! Turn your body into a fat burning machine,  not a fat storage machine!

6) Lastly, the key secret in weight loss is to not focus on diet. It has to be a lifestyle change – for life.  When you lose weight through lifestyle change, you also change the lifestyles of others surrounding you.

Reference:

Caloric Restriction Experience Reprograms Stress and Orexigenic Pathways and Promotes Binge Eating. The Journal of Neuroscience, December 01, 2010.

other links:

Daily Calorie Requirement Chart: http://www.positivehealthsteps.com/calories/daily-required.shtml

http://www.livestrong.com/article/12733-why-calorie-restriction-weight-loss/#ixzz1spVqfWWC

Posted in Nutrition | Tagged , , , , , , , , | 1 Comment

Vit K2! How does it help my bone health?

Many people have heard of the importance of Vitamin D in bone health. How many people know about the importance of Vitamin K2 in bone health? Do you? So what does Vitamin K2 do?

bone density femur female

bone density femur female (Photo credit: Wikipedia)

Studies show that treatment with vitamin D3 slightly reduces bone turnover, sustains bone mineral density (BMD), and prevents osteoporotic vertebral fractures in postmenopausal women with osteoporosis, while vitamin K2  enhances secretion of osteocalcin (a protein for bone formation), sustains BMD, increase bone strength independently of BMD and prevents osteoporotic fractures in patients with osteoporosis. Studies also suggest that combination of Vitamin D3 and Vitamin K2 enhances the effect of each other. There also seems to be some evidence suggesting that nutritional supplements such as active vitamin D3 and vitamin K2 are effective in reducing the fracture incidences.

Not only Vitamin K2 keeps calcium in your bones, it also keeps calcium out of your arteries.

Are there other Vitamin K?  Vitamin K1 allows the blood to clot and has anti-inflammatory effects. It is also found in many foods. However, Vitamin K2 is less common in foods.

What are the natural source of Vit K2?

  • K2 is found fermented food such as curd cheese (from grass-fed animal products)
  • natto, a fermented soy beans eaten in Japan

There are some K2 supplement available in today’s market. I use one that is already combined with Vitamin D3 in powder form (Vitamin D with K2). This is ideal to me because it can be consumed as a liquid form which allows maximum and quickest absorption. In addition, it is would easy to ingest for the elderly as well. Vitamin K is fat soluble. It should be consumed with food.

References
Posted in Bone Health | Tagged , , , , , , , , , , | 5 Comments

Cruciferous Veggies Boost Survival in Breast Cancer Patients

Eating cruciferous vegetables might improve the survival rate in breast cancer patients, according to the results of a new study.

Breast cancer awareness reception

Breast cancer awareness reception (Photo credit: Downing Street)

At the American Association for Cancer Research 103rd Annual Meeting, the Shanghai Breast Cancer Survival Study showed that eating cruciferous vegetables during the first 36 months after a diagnosis of breast cancer was associated with a reduced risk for total mortality, breast-cancer-specific mortality, and recurrence in a population of 4886 Chinese women. (read full article)

The risk for total mortality decreased by 27% (to 62%), the risk for breast-cancer-specific mortality decreased by 22% (to 62%), and the risk for recurrence decreased by 21% (to 35%).

Dr. Nechuta, the lead researcher of the study, commented the following from the study:

  • commonly consumed cruciferous vegetables in China include turnip, Chinese cabbage/bok choy; where as broccoli and brussels sprouts are the most commonly consumed curciferous vegetables in U.S and other Western countries
  • the amount of intake among Chinese women is much higher than that of American women

Cruciferous vegetables include the following: bok choy, broccoli, turnip, brussels sprouts, cauliflower, cabbage, kale, rutabaga, arugula

Posted in Nutrition | Tagged , , , , , , , , , , , | Leave a comment