Amy Joy Lanou

Calcium, Dairy Products, and Bone Health in Children and Young Adults: A Reevaluation of the Evidence

Objective. Numerous nutrition policy statements recommend the consumption of 800 to 1500 mg of calcium largely from dairy products for osteoporosis prevention; however, the findings of epidemiologic and prospective studies have raised questions about the efficacy of the use of dairy products for the promotion of bone health. The objective of this study was to review existing literature on the effects of dairy products and total dietary calcium on bone integrity in children and young adults to assess whether evidence supports (1) current recommended calcium intake levels and (2) the suggestion that dairy products are better for promoting bone integrity than other calcium-containing food sources or supplements. Methods. A Medline (National Library of Medicine, Bethesda, MD) search was conducted for studies published on the relationship between milk, dairy products, or calcium intake and bone mineralization or fracture risk in children and young adults (1–25 years). This search yielded 58 studies: 22 cross-sectional studies; 13 retrospective studies; 10 longitudinal prospective studies; and 13 randomized, controlled trials. Results. Eleven of the studies did not control for weight, pubertal status, and exercise and were excluded. Ten studies were randomized, controlled trials of supplemental calcium, 9 of which showed modest positive benefits on bone mineralization in children and adolescents. Of the remaining 37 studies of dairy or unsupplemented dietary calcium intake, 27 studies found no relationship between dairy or dietary calcium intake and measures of bone health. In the remaining 9 reports, the effects on bone health are small and 3 were confounded by vitamin D intake from milk fortified with vitamin D. Therefore, in clinical, longitudinal, retrospective, and cross-sectional studies, neither increased consumption of dairy products, specifically, nor total dietary calcium consumption has shown even a modestly consistent benefit for child or young adult bone health. Conclusion. Scant evidence supports nutrition guidelines focused specifically on increasing milk or other dairy product intake for promoting child and adolescent bone mineralization.

Dairy and weight loss hypothesis: an evaluation of the clinical trials.

This review evaluates evidence from clinical trials that assessed the effect of dairy product or calcium intake, with or without concomitant energy restriction, on body weight and adiposity. Of 49 randomized trials assessing the effect of dairy products or calcium supplementation on body weight, 41 showed no effect, two demonstrated weight gain, one showed a lower rate of gain, and five showed weight loss. Four of 24 trials report differential fat loss. Consequently, the majority of the current evidence from clinical trials does not support the hypothesis that calcium or dairy consumption aids in weight or fat loss.

Acceptability of a low-fat vegan diet compares favorably to a step II diet in a randomized, controlled trial.

PURPOSE This study aimed to assess the acceptability of a low-fat vegan diet, as compared with a more typical fat-modified diet, among overweight and obese adults. METHODS Through newspaper advertisements, 64 overweight, postmenopausal women were recruited, 59 of whom completed the study. The participants were assigned randomly to a low-fat vegan diet or, for comparison, to a National Cholesterol Education Program Step II (NCEP) diet. At baseline and 14 weeks later, dietary intake, dietary restraint, disinhibition, and hunger, as well as the acceptability and perceived benefits and adverse effects of each diet were assessed. RESULTS Dietary restraint increased in the NCEP group (P <.001), indicating a greater subjective sense of constraint with regard to diet requirements, but was unchanged in the vegan group. Disinhibition and hunger scores fell in each group (P <.001 and P <.01, respectively). The acceptability of both diets was high, although the vegan group participants rated their diet as less easy to prepare than their usual diets (P <.05) and the NCEP participants foresaw continuation of their assigned diet to be more difficult than continuation of their baseline diets (P <.05). There were no between-group differences on any acceptability measures. CONCLUSIONS The acceptability of a low-fat vegan diet is high and not demonstrably different from that of a more moderate low-fat diet among well-educated, postmenopausal women in a research environment.

The Consumer Cost of Calcium From Food and Supplements

Nutritional authorities encourage consumers to include calcium-rich foods in their daily diets. However, consumer purchases are driven not only by health considerations and dietary preferences, but also by cost. This study assessed the cost of calcium from a wide variety of food sources, as well as supplements, based on retail prices in Seattle, San Francisco, Raleigh, NewYork City, and Washington, D.C., while controlling for seasonal variation. Costs were adjusted based on calcium absorption fractions. Calcium carbonate supplements emerged as the least expensive source of calcium, at roughly one-third the cost of the least expensive food source of calcium. The least expensive food sources of calcium were Total cereal, skim milk, and calcium-fortified orange juice from frozen concentrate. This information is useful for dietitians, health professionals, and consumers in meeting calcium requirements on a budget.

Applying the Precautionary Principle to Nutrition and Cancer

Primary Objective: Research has identified certain foods and dietary patterns that are associated with reduced cancer risk and improved survival after cancer diagnosis. This research has formed the basis for dietary guidance issued by cancer organizations. Unfortunately, gaps within nutrition research have made it difficult to make recommendations in some areas. This review specifies suggested dietary guidance in which evidence of a dietary influence on cancer risk is substantial, even if not conclusive. Evidence summaries within the review are based on the 2007 report of the World Cancer Research Fund/American Institute for Cancer Research. This review also describes advantages and disadvantages of following the suggested dietary guidance and includes putative mechanisms involved in cancer progression. Main Outcomes and Results: Suggested dietary guidance where evidence is sufficiently compelling include (1) limiting or avoiding dairy products to reduce the risk of prostate cancer; (2) limiting or avoiding alcohol to reduce the risk of cancers of the mouth, pharynx, larynx, esophagus, colon, rectum, and breast; (3) avoiding red and processed meat to reduce the risk of cancers of the colon and rectum; (4) avoiding grilled, fried, and broiled meats to reduce the risk of cancers of the colon, rectum, breast, prostate, kidney, and pancreas; (5) consumption of soy products during adolescence to reduce the risk of breast cancer in adulthood and to reduce the risk of recurrence and mortality for women previously treated for breast cancer; and (6) emphasizing fruits and vegetables to reduce risk of several common forms of cancer. Conclusion: By adopting the precautionary principle for nutrition research, this review aims to serve as a useful tool for practitioners and patients.

Reduced cancer risk in vegetarians: an analysis of recent reports.

This report reviews current evidence regarding the relationship between vegetarian eating patterns and cancer risk. Although plant-based diets including vegetarian and vegan diets are generally considered to be cancer protective, very few studies have directly addressed this question. Most large prospective observational studies show that vegetarian diets are at least modestly cancer protective (10%–12% reduction in overall cancer risk) although results for specific cancers are less clear. No long-term randomized clinical trials have been conducted to address this relationship. However, a broad body of evidence links specific plant foods such as fruits and vegetables, plant constituents such as fiber, antioxidants and other phytochemicals, and achieving and maintaining a healthy weight to reduced risk of cancer diagnosis and recurrence. Also, research links the consumption of meat, especially red and processed meats, to increased risk of several types of cancer. Vegetarian and vegan diets increase beneficial plant foods and plant constituents, eliminate the intake of red and processed meat, and aid in achieving and maintaining a healthy weight. The direct and indirect evidence taken together suggests that vegetarian diets are a useful strategy for reducing risk of cancer.

Salt level in weaning diet affects saline preference and fluid intake in Dahl rats.

Weanling Dahl salt-sensitive (DS) and salt-resistant (DR) rats were used to compare effects of feeding high or low NaCl diets on taste preference for, and intake of, a wide range of saline concentrations. The DS and DR were fed either 8.0 or 0.4% dietary NaCl for 4 weeks. Then, with all animals fed the 0.4% NaCl diet, their taste preferences for 0.0001 to 0.56 M saline were assessed using three 24-hour two-bottle preference tests of each solution versus distilled deionized water. Saline preference and intake were influenced by concentration and its interaction with genotype, with DS exhibiting higher preferences than DR for hypotonic saline. The DS preexposed to 8.0% dietary NaCl showed elevated consumption levels of water and total fluid (saline + water) that persisted throughout the 5-week test period, despite transfer to the 0.4% NaCl diet before the initiation of preference testing. Findings indicate that genotype, dietary NaCl levels in weaning diet, and saline concentration of preference test solutions interact to influence saline preference and saline and water intake in Dahl rats.

Bone health in children

Guidelines for calcium intake should be revised

Współ-pisanie, współ-poznawanie. Transformujące epistemologie

Our article offers a vision of how collaborative processes of knowledge-making in an interdisciplinary faculty writing group can transform professional lives of isolation into ones that flourish. Central to our co-creation of knowledge are the practice of storytelling in a critical self-reflective manner and the elements of commitment, connection and relationship. Together we have found that these elements provide basic strategies for managing the isolation that would otherwise be a significant force in our working lives. Our commitment is epistemological and moral, as we commit to knowledge-making, but also to each other as individuals and as moral agents, to our values, and to bringing our values into our work. Learning about ourselves together can enhance our sense of identity and our ability to navigate limits and boundaries. Through supportive, intentional and reflective collaboration, we re-vision knowledge-making as fundamentally social and relational, and theorizing as grounded in the specificity of narratives of shared, lived experience.