Calcium supplements?

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Calcium supplements?

Postby FrauMomandant » Thu Feb 14, 2008 2:04 pm

I've been on the McDougall Plan for 3 weeks, and am feeling great. I'm wondering if I need a calcium supplement, or what your opinion on supplements might be.

Because I am asthmatic, and use a steroid inhaler twice daily(and have for a number of years) it makes sense to me to take a supplement. What do you think?
Keeping the home fires burning,

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Re: Calcium supplements?

Postby JeffN » Thu Feb 14, 2008 2:27 pm

FrauMomandant wrote:I've been on the McDougall Plan for 3 weeks, and am feeling great. I'm wondering if I need a calcium supplement, or what your opinion on supplements might be.

Because I am asthmatic, and use a steroid inhaler twice daily(and have for a number of years) it makes sense to me to take a supplement. What do you think?


Congratulations on becoming a McDougaller! I am glad to hear you are feeling great and am sure this will only get better.

The McDougall diet can easily supply enough calcium without the need of supplements. Eat plenty of whole foods and try to include some dark greens like kale, collard, and bok choy. In addition, getting some weight bearing activity (like walking) every day, getting some vit D from the sun on a regular basis, eliminating animal protein and reducing the salt in your diet, will all help with maintaining a positive calcium balance.

You may also find that by following the McDougall program your asthma starts improving and your need for the steroid inhaler lessens.

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Postby FrauMomandant » Thu Feb 14, 2008 2:54 pm

Thank you for responding so quickly! I'll look for some leafy greens at the market today! :-)
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Vitamin D

Postby Rita » Fri Feb 15, 2008 4:21 am

Here's the thing, if one lives in a cold climate, and doesn't take supplements, how does one get enough Vitamin D? What foods supply it? Thanks
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Re: Vitamin D

Postby JeffN » Fri Feb 15, 2008 11:19 am

Rita wrote:Here's the thing, if one lives in a cold climate, and doesn't take supplements, how does one get enough Vitamin D? What foods supply it? Thanks


Hi Rita,

This is a great question that has been in the news a lot lately

Vit D is really a hormone and we manufacture it as a response to sunlight. Lately, there has been a growing concern that Vit D deficiency is a problem in those who live in Northern climates or other geographical areas, where sunlight is limited.

Personally, I think much of this has to do with the fall-out and/or backlash from our 2-3 decade fear of getting skin cancer from over exposure to sun and there are some studies that support this.

Nowson C, Margerison C (2002). "Vitamin D intake and vitamin D status of Australians". Med J Aust 177 (3): 149-52. PMID 12149085.

The pendulum seems to have swung in the opposite direction and we became a nation of people afraid to venture out in the sun at any point and when outside we cover out bodies with high SPF sunscreens, wear clothing that is now made with suncreen and live in homes and drive cars with windows that block UV rays. I have sat in lectures from prominent skin care doctors (dermatologists, plastic surgeons) who have warned attendees that the only safe sun exposure is none. This is silly.

The irony is that while excess sun may cause cancer, the lack of Vit D can also increase cancer risks and a recent analysis showed the benefit of some sum exposure may outweigh any potential risk.

Very few foods naturally contain significant amounts of vitamin D so much of the Vit D in the food supply is from fortified foods (like dairy milk, breakfast cereals and bread). These represent the major dietary sources of vitamin D

Some interesting recent research has shown that mushrooms may be able to provide Vit D (~2700 IU per serving of vitamin D2), if they are exposed to a few minutes of UV light after being harvested or if they are exposing to about three hours of artificial UV light during growing, and this may become one of the few natural sources (outside of sunlight) of vitamin D for vegans if the industry adopts this practice.

In latitudes around 40 degrees north or 40 degrees south (Boston is 42 degrees north), there is insufficient UVB radiation available for vitamin D synthesis from November to early March. Ten degrees farther north (Edmonton, Canada) or south, the ‚Äúvitamin D winter‚ÄĚ extends from mid-October to mid-March.

However, according to Dr. Michael Holick (one of our nations leading Vit D experts), as little as 5-10 minutes of sun exposure on arms and legs or face and arms three times weekly between 11:00 am and 2:00 pm during the spring, summer, and fall at 42 degrees latitude should provide a light-skinned individual with adequate vitamin D and allow for storage of any excess for use during the winter with minimal risk of skin damage.

Holick MF. Vitamin D deficiency: what a pain it is. Mayo Clin Proc. 2003;78(12):1457-1459.

http://www.anaboliclabs.com/User/Docume ... 202003.pdf

Although this is often the time zone we hear to avoid being in the sun, it is also the most effective time zone to produce Vit D, so getting a limited exposure during this time may be the best solution and then to use sunscreen for any additional time in the sun during this time zone.

That would be my recommendation.

If you are concerned, you can get your Vit D levels checked. And/or if you are really concerned about it, you can get a fairly inexpensive UV Meter that will read the UV levels where you live which can help you decide how much time you need to spend in the sun that day.

Or move down here to Florida or out west to California! :)

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Postby f. kwan » Fri Feb 15, 2008 3:26 pm

Hi Jeff!

I live in Texas and get at least an hour of sunlight a day and still had vitamin D blood levels at 21 (deficiency) last year. I began taking 1000 IU about six months ago. As far as I can tell, mushrooms (and other plant sources) only provide D2 and animal sources only D3. Will I be lacking anything taking the D2 only?

Thanks,

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Re: Vitamin D

Postby Rita » Sat Feb 16, 2008 11:20 am

JeffN wrote:[quote="
Or move down here to Florida or out west to California! :)
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Now that's the best solution for me! I've always wanted to move to FL.

So, I was there for a week and spent at least an hour walking in the sun (but around 10:00 a.m.). Do you think could have gotten much Vitamin D in that short a time?
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Postby JeffN » Sat Feb 16, 2008 12:11 pm

f. kwan wrote:Hi Jeff!

I live in Texas and get at least an hour of sunlight a day and still had vitamin D blood levels at 21 (deficiency) last year. I began taking 1000 IU about six months ago. As far as I can tell, mushrooms (and other plant sources) only provide D2 and animal sources only D3. Will I be lacking anything taking the D2 only?


Hi,

There are some misconceptions about Vitamin D2

Just to clarify:

There are two types of vitamin D:

Vitamin D3 - cholecalciferol; is derived from animals (usually from sheep's wool or fish oil). It is the preferred form that is usually recommended as studies have shown it to be more effective, and it is the form animals (including humans) synthesize from sunlight.

Vitamin D2 - ergocalciferol; a plant chemical that is the form synthesized by plants. It has vitamin D activity in humans, but not as much activity as D3;

While D3 has been shown to be more effective (some studies have estimated it to be about 3- 10x more effective) it doesn't mean that D2 is ineffective.

If you are avoiding animal products, and are unable to get enough Vit D from exposure to sunlight, a Vit D2 supplement may be a solution, but you may have to take more of it, or take it more often.

The reason is that in a study done in 2004, subjects were given one dose of 50,000 IU of vitamin D2 or vitamin D3. Vitamin D2 was absorbed just as well as vitamin D3. However, after three days, blood levels of 25(OH)D decreased rapidly in the subjects who were given vitamin D2 and by 14 days they had fallen to the original level. Those who received vitamin D3 sustained high levels for two weeks before dropping gradually. This seems to indicates that vitamin D2 needs to be taken at least every three days to maintain adequate blood levels.

Quoting from the study..

The relative potencies of vitamins D(2) and D(3) were evaluated by administering single doses of 50,000 IU of the respective calciferols to 20 healthy male volunteers, following the time course of serum vitamin D and 25-hydroxyvitamin D (25OHD) over a period of 28 d and measuring the area under the curve of the rise in 25OHD above baseline.The two calciferols produced similar rises in serum concentration of the administered vitamin,indicating equivalent absorption. Both produced similar initial rises in serum 25OHD over the first 3 d, but 25OHD continued to rise in the D(3)-treated subjects, peaking at 14 d, whereas serum 25OHD fell rapidly in the D(2)-treated subjects and was not different from baseline at 14 d.

(Armas LA, Hollis BW, Heaney RP. Vitamin D2 is much less effective than vitamin D3 in humans. J Clin Endocrinol Metab. 2004 Nov;89(11):5387-91.)

Here are a few more studies with relevant info

Eur J Clin Nutr. 2006 May;60(5):681-7. Vitamin D2 dose required to rapidly increase 25OHD levels in osteoporotic women. Mastaglia SR, Mautalen CA, Parisi MS, Oliveri B.

OBJECTIVE: Assessment of the effectiveness and safety of high daily 125 microg (5,000 IU) or 250 microg (10,000IU) doses of vitamin D(2) during 3 months, in rapidly obtaining adequate 25 hydroxyvitamin D (25OHD) levels.

DESIGN: Longitudinal study.

SUBJECTS: Postmenopausal osteopenic/osteoporotic women (n = 38 ) were studied during winter and spring. Median age (25-75th percentile) was 61.5 (57.00-66.25) years, and mean bone mineral density (BMD) was 0.902 (0.800-1.042)g/cm(2). Subjects were randomly divided into three groups: control group (n=13): no vitamin D(2), 125 mug/day (n=13) and 250 microg/day (n=12) of vitamin D(2) groups, all receiving 500 mg calcium/day. Serum calcium, phosphate, bone alkaline phosphatase (BAP), C-telopeptide (CTX), 25OHD, mid-molecule parathyroid hormone (mmPTH), daily urinary calcium and creatinine excretion were determined at baseline and monthly.

RESULTS: For all subjects (n=38 ), the median baseline 25 hydroxyvitamin D (25OHD) level was 36.25 (27.5-48.12) nmol/l. After 3 months, 8% of the patients in the control group, 50% in the 125 microg/day group and 75% in the 250 microg/day group had 25OHD values above 85 nmol/l (34 ng/ml). Considering both vitamin D(2) groups together, mmPTH and BAP levels diminished significantly after 3 months (P<0.02), unlike those of CTX. Serum calcium remained within normal range during the follow-up.

CONCLUSIONS: The oral dose of vitamin D(2) required to rapidly achieve adequate levels of 25OHD is seemingly much higher than the usual recommended vitamin D(3) dose (20 mug/day). During 3 months, 250 microg/day of vitamin D(2) most effectively raised 25OHD levels to 85 nmol/l in 75% of the postmenopausal osteopenic/osteoporotic women treated.

Also..

J Steroid Biochem Mol Biol. 2004 May;89-90(1-5):601-4.Effect of Vitamin D supplement use on serum concentrations of total 25OHD levels in elderly women.

Concluded: Vitamin D deficiency was less prevalent in elderly women taking Vitamin D(2) supplements (1.8%) compared to women not taking any supplements (12%).

And..

Calcif Tissue Int. 2004 Feb;74(2):150-6. Epub 2003 Dec 5. Effect of vitamins D2 and D3 supplement use on serum 25OHD concentration in elderly women in summer and winter.

Concluded: In elderly subjects, both vitamin D2 and Vitamin D3 supplements may contribute equally to circulating 25OHD levels, with the role of vitamin D supplement use being more predominant during winter.

So, Vit D2 may be adequate, but it may take a higher dose or one taken more often.

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Re: Vitamin D

Postby JeffN » Sat Feb 16, 2008 12:16 pm

Hi Rita,

Rita wrote: Now that's the best solution for me! I've always wanted to move to FL.


One of the reasons I moved here. Besides my family being here, I love the year round sun, the year round warm weather and the incredible year round availability of fresh (and exotic) produce.

Rita wrote: So, I was there for a week and spent at least an hour walking in the sun (but around 10:00 a.m.). Do you think could have gotten much Vitamin D in that short a time?


I am sure you did, but while Vit D is fat soluble and can be stored up in the body, one week probably would not have produced much storage. But, it is hard to tell.

Guess you will have to come back.

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Re: Vitamin D

Postby Rita » Sun Feb 17, 2008 12:06 pm

JeffN wrote:Hi Rita,

Rita wrote: Guess you will have to come back.

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Plan to do so, but not till next January.

I had my Vit. D Hydroxy 25 done in August. It was 19! Having it done again this week. So will see how it turns out.

Thanks for your input on this board....
Rita
 

Postby JeffN » Wed Jun 04, 2008 3:57 pm

More info and a great article on the topic

"Michael F. Holick, PhD, MD, is professor of medicine, physiology, and biophysics; director of the General Clinical Research Center; and director of the Bone Health Care Clinic and the Heliotherapy, Light, and Skin Research Center at Boston University Medical Center." The below interview is in a free full-text paper.


ALTERNATIVE THERAPIES, May/jun 2008, VOL. 14, NO. 3, 64-75.
Conversations: Michael Holick, PhD, MD.
MICHAEL HOLICK, PHD, MD: VITAMIN D PIONEER.
Interview by Frank Lampe and Suzanne Snyder. Photography by David Keough.

http://www.alternative-therapies.com/at ... erview.pdf

MICHAEL HOLICK, PHD, MD: VITAMIN D PIONEER
ALTERNATIVE THERAPIES, May/jun 2008, VOL. 14, NO. 3

ATHM: Has recent research shown that both vitamin D 2 and D3 are equally effective at increasing the levels of 25-hydroxyvitamin D? This is in opposition with earlier studies, is it not?

Dr Holick: That‚Äôs correct. There was a study done in Canada in which researchers gave a group of adults 4000 IU of vitamin D 2 or 4000 IU of vitamin D 3 in ethanol for a period of 2 weeks and showed wide variability, and there appeared to be a 50% reduction in the 25-hydroxyvitamin D levels in the adults who were taking vitamin D 2. This implied that vitamin D2 was less effective than vitamin D 3. The second study that set this kindling on Ô¨Ā re was the observation by Dr Heaney‚Äôs group. They gave a single 50 000-IU dose of vitamin D 2 or a single 50 000-IU dose of vitamin D3 to healthy adults in the summertime. When they followed their 25-hydroxyvitamin D levels, they found that the levels more rapidly declined in the group that got that single dose of vitamin D 2. But more importantly and alarmingly was that the 25-hydroxyvitamin D 3 in those same subjects more rapidly declined than the subjects who received a placebo, implying that the vitamin D 2 induced the destruction of vitamin D 3. Therefore, not only was vitamin D 2 less active, but it caused the destruction of vitamin D3.

I decided to conduct a study in which we gave 1000 IU of Vitamin D 2 or 1000 IU of vitamin D3 to healthy adults at the end of the winter‚ÄĒDr Heaney‚Äôs study was done in the summer, and sun exposure may have inÔ¨ā uenced the outcome of the study. We found that vitamin D 2 raised the blood levels of 25-hydroxyvita-min D identically to the group that took vitamin D 3. More importantly, to leave no stone unturned, we also made a capsule that contained 500 IU of vitamin D 2 and 500 IU of vitamin D 3 and showed that the 25-hydroxyvitamin D levels increased exactly the same degree for the 25-hydroxyvitamin D 2 and 25-hydroxyvitamin D 3 and that there was no alteration in the 25-hydroxyvitamin D 3 levels in the group that got vitamin D 2. That, to me, proves that vitamin D 2 is as effective as vitamin D 3 in raising and maintaining 25-hydroxyvitamin D levels. That is consistent with the early literature that showed that 100 IU of vitamin D 2 was effective in preventing rickets in children.

ATHM: How much vitamin D does a person get from exposure
to the sun?

Dr Holick: We did a study that showed that if you expose a person in a bathing suit to what we call 1 minimal erythemal dose, which is a light pinkness to the skin 24 hours after sun exposure, it’s equivalent to taking between 15 000 and 20 000 IU of vitamin D 3. For a white adult, that would be equivalent to being exposed to sunlight in June at noon for about 10-15 minutes on a Cape Cod beach. Your body has a huge capacity to make vitamin D. What’s interesting is that the sunlight destroys any excess vitamin D that your body makes, so you could never become vitamin D intoxicated from sun exposure.
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Postby JeffN » Wed Sep 10, 2008 7:38 pm

Contrary to a many admonitions claiming that Americans, especially seniors, must take vitamin D supplements because their skin can no longer generate sufficient vitamin D when out in the sun, seniors' vitamin D generating capability is apparently just as good as that of young people, a recent study reports:

Am J Epidemiol. 2008 Sep 15;168(6):577-86. Epub 2008 Jun 25.

Frequency of Leisure-Time Physical Activity and Serum 25-Hydroxyvitamin
D Levels in the US Population: Results from the Third National Health
and Nutrition Examination Survey.Scragg R, Camargo CA Jr.

The decline in vitamin D status among older people is probably due to
decreased synthesis of vitamin D by sun-exposed skin and/or decreased
outdoor activity. The authors examined the association between outdoor
leisure physical activity and serum 25-hydroxyvitamin D in the Third
National Health and Nutrition Examination Survey (1988-1994) (n = 15,148
aged >/=20 years). The mean 25-hydroxyvitamin D concentration declined
with increasing age, with 79, 73, and 68 nmol/liter for persons aged
20-39, 40-59, and 60 or more years. The proportion that engaged in
outdoor activity in the past month was 80% for persons aged 20-39 and
40-59 years but 71% for those aged 60 or more years. In contrast, the
mean difference in 25-hydroxyvitamin D between those who participated in
outdoor activities daily compared with those who did not participate in
the past month was similar for the youngest and oldest age groups: 13
and 16 nmol/liter, respectively. Those persons aged 60 or more years who
participated in daily outdoor activities had a mean 25-hydroxyvitamin D
concentration similar to that of persons aged 20-39 years: 77 versus 79
nmol/liter, respectively. These nationally representative data suggest
that persons aged 60 or more years can synthesize enough vitamin D from
daily outdoor activities to maintain vitamin D levels similar to those
of young adults.


PMID: 18579538

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Postby r-marie » Sat Sep 13, 2008 8:19 pm

JeffN wrote: Eat plenty of whole foods and try to include some dark greens like kale, collard, and bok choy.

Jeff, I've been meaning to ask you re calcium: I don't like to eat these greens every day - once a week is enough for me - I prefer to eat green salads. So...would green leaf or Romaine lettuce or spring mix do just as well to furnish enough calcium? I also have chives, parsely and garlic chives in my garden which I add to my meals.

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Calcium

Postby JeffN » Sun Sep 14, 2008 6:55 pm

r-marie wrote:JeffN wrote: Eat plenty of whole foods and try to include some dark greens like kale, collard, and bok choy.

Jeff, I've been meaning to ask you re calcium: I don't like to eat these greens every day - once a week is enough for me - I prefer to eat green salads. So...would green leaf or Romaine lettuce or spring mix do just as well to furnish enough calcium? I also have chives, parsely and garlic chives in my garden which I add to my meals.

r-marie


All greens are good source of calcium per calorie. Here is a list of several. Remember, you do not need the "most" or the "highest" all the time.

Calcium Per 100 Calories

Water Cress 1102
Bok Choy 774
Turnip greens 685
Arugula 640
Collared Greens 583
Parsley 534
Mustard Greens 493
Chinese Broccoli 453
Beet Greens 422
Broccoli Raab 357
Chives 309
Kale 257
Green Leaf 241
Romaine 194

Cooked Broccoli 114

Just keep including the ones you like and if you can, try to include some of the more calcium dense ones whenever you can.

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Postby McBastard » Mon Dec 15, 2008 10:03 am

Jeff,
Your list of green leafy veggies that supply Calcium is rather "exotic". I dont think I've ever heard of many of them before, and certainly dont get to eat most of them in my usual meals. My "veggies" are mostly carrots, potatoes, beans, onions, the occasional bitter gourd, lady's finger, radish ... basically the more "common" veggies.

Do such vegetables (And fruits) supply appreciable quantities of calcium that'd help attain the Recommended daily quantity which I think is about 1000 mg?

I have not been sure of that and so have begun to rely on fortified wholemeal bread (300 mg calcium from 100 g of bread), soy milk (450 mg from 250 ml per day, following your advice of no more than one cup soy milk a day :) ), and fortified orange juice (100 mg Ca from 200 ml) for my daily calcium needs.

Is it possible that I might be getting insufficient calcium without following the above combination? Although when I think of it, I am hardly ever in the sun, so I might not be getting enough vit D :(
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