The New Optimum Nutrition Bible

by Patrick Holford

  Prostaglandins, made from essential fatty acids, sensitize cells to hormones. There is considerable interaction between prostaglandins and hormones, especially sex hormones. Deficiency in essential fats, which is endemic in the Western world, or deficiency in the nutrients needed to convert essential fats into prostaglandins (vitamins B3, B6, and C and biotin, magnesium, and zinc), can also create the equivalent of hormonal imbalances.

  These nutrients, plus essential fats, have proved very helpful in relieving PMS and menopausal symptoms. So too have the herbs agnus castus, dong quai, black cohosh, and St. John’s wort. Vitamin E is also helpful for menopausal symptoms. One possible explanation is that vitamin E protects essential fats and prostaglandins from oxidation.

  Balancing your hormones

  The following guidelines will help you keep your hormones in balance. However, if you are suffering from a major hormone imbalance such as estrogen dominance, it may be necessary also to take small amounts of natural progesterone. This is very different from synthetic progestins, which are included in some birth control pills and HRT, often in massive amounts in comparison to what the body naturally produces. Natural progesterone (and, for men, testosterone) is available only on prescription.

  To keep your hormones in balance

  Keep animal fats very low in your diet.

  Choose organic vegetables and meat wherever possible to reduce pesticide and hormone exposure.

  Don’t eat fatty foods wrapped in PVC cling film.

  Use stimulants such as coffee, tea, chocolate, sugar, and cigarettes infrequently, if at all. If you are addicted to any of these, break the habit.

  Do not let stress become a habit in your life. Identify sources of stress and make some positive changes to your circumstances and the way you react to them.

  Make sure you are getting enough essential fats from seeds, their oils, or supplements of evening primrose or borage oil (omega-6) or flax oil (omega-3).

  Make sure your supplement program includes optimal levels of vitamins B3 and B6, biotin, magnesium, and zinc.

  If you have PMS or menopausal symptoms, consider taking a hormone-friendly supplement containing extra vitamins B3, B6, and C, and biotin, magnesium, and zinc, and/or the herbs agnus castus, dong quai, black cohosh, and St. John’s wort (see Resources).

  Read more about balancing hormones in my book Balancing Hormones Naturally, coauthored with Kate Neil.

  26

  Bone Health—A Skeleton in the Cupboard

  Not many people think about nourishing their skeleton. There is almost a belief that once your bones are formed they are there for good—until they start to break down, as in arthritis or osteoporosis. Yet the bones, like every other part of the body, are continually being rebuilt. They are a structure of protein and collagen (a kind of intercellular glue) that collects mainly calcium, plus phosphorus and magnesium. We even store heavy metals like lead in our bones when our body cannot get rid of them.

  There are two kinds of bone cells: osteoblasts build new bone, while osteoclasts break down and get rid of old bone. The bone ends are made of cartilage, which is softer so joints can work smoothly. While bones use calcium, phosphorus, and magnesium as building materials, the ability to absorb calcium into bones depends on vitamin D and is assisted by the trace mineral boron. Vitamin C makes collagen, and zinc helps make new bone cells. This orchestra of nutrients is often found in “bone-friendly” supplements.

  Osteoporosis

  The epidemic of osteoporosis has made many women think seriously about the health of their bones. It is the silent thief that robs up to 25 percent of your skeleton by the time you reach the age of fifty. Particularly prevalent in women after menopause, it increases the risk of bone fractures that occur in one in three women and one in twelve men by the age of seventy.

  The conventional explanation is that once a woman stops menstruating she produces little of the estrogen that helps keep calcium in her bones, hence the recommendation for women to have hormone replacement therapy (HRT). But this is far from the truth. Firstly, analyses of skeletal remains of our ancestors, and across cultures, show that postmenopausal women do not routinely suffer decreased bone density It is a more recent phenomenon, particularly in Western society. Secondly, estrogen, which stimulates osteoclast cells, does not help build new bone but only stops the loss of old bone. Progesterone, on the other hand, stimulates osteoblasts, which do build new bone. Taking natural progesterone increases bone density four times more effectively than estrogen.

  In the time leading up to menopause, and afterward, a woman stops ovulating. If no ovum is released, no progesterone is produced, even though the body continues to produce small amounts of estrogen. Scientists are now coming around to thinking that it is the relative excess of estrogen relative to progesterone, which is in effect progesterone deficiency, that is precipitating osteoporosis, not deficiency in estrogen.

  Typical bone mass density changes in menopausal women.

  Of course, this is not the only factor. Changes in diet are strongly related to increased risk of osteoporosis and may explain why many cultural groups have no osteoporosis at all. But while people with very low calcium intakes may benefit from taking more, there is no strong association between osteoporosis and calcium levels. The Bantu tribes of Africa, for example, have an average calcium intake of 400 mg a day, well below the recommended intake for postmenopausal women, yet have virtually no osteoporosis. And the Inuit (Eskimos), who consume vast amounts of calcium, have an exceptionally high incidence of osteoporosis. Why? And what have countries and cultures with a high incidence of osteoporosis got in common? The answer certainly isn’t a lack of calcium, since milk consumption is exceedingly high in both the United States and the United Kingdom, where osteoporosis is endemic. It may be too much dietary protein.

  Protein-rich foods are acid-forming. The body cannot tolerate substantial changes in acid level in the blood and neutralizes this effect through two main alkaline agents—sodium and calcium. When the body’s reserves of sodium are used up, calcium is taken from the bones. Therefore, the more protein you eat, the more calcium you need. One big difference between the Bantus and the Inuit is their level of protein consumption.

  The idea that high-protein diets lead to calcium deficiency is nothing new. Numerous studies have demonstrated that a high protein intake increases urinary calcium excretion and that, on average, 1 mg of calcium is lost in urine for every 1 g rise in dietary protein. This effect is primarily attributable to metabolism of sulfur-containing amino acids present in all animal and some vegetable proteins, resulting in a greater acid load and buffering response by the skeleton—your body uses calcium to neutralize the acid.30 And research is beginning to show that if you eat a high-protein diet no amount of calcium will correct the imbalance.

  In one piece of research published in the American Journal of Clinical Nutrition, the group of people studied were given either a moderately high-protein diet (80 g protein a day) or a very high-protein diet (240 g protein) plus 1400 mg of calcium. The overall loss of calcium was 37 mg per day on the 80 g protein diet and 137 mg per day on the diet with 240 g protein diet. The author concluded that “high-calcium diets are unlikely to prevent probable bone loss induced by high-protein diets.” In another study, a protein intake of 95 g a day (bacon and eggs for breakfast supplies 55 g) resulted in an average calcium loss of 58 mg per day, which means a loss of 2 percent of total skeletal calcium per year, or 20 percent each decade. The negative effects of too much protein have been clearly demonstrated in patients with osteoporosis. Some medical scientists now believe that a lifelong consumption of a high-protein, acid-forming diet may be a primary cause of osteoporosis.

  Say no to arthritis

  According to Dr. Robert Bingham, a specialist in the treatment of arthritis, “No person who is in good nutritional health develops rheumatoid or osteoarthritis.” Yet by the age of sixty, nine in every ten people have it. For some it is a living hell that can even be life
threatening. For all of them, arthritis means living with pain and stiffness. Arthritis is not, however, an inevitable consequence of aging and can be prevented, provided the underlying causes are eliminated.

  In the search for the cause of arthritis, many things have been considered, including diet, physical exercise, posture, climate, hormones, infections, genetics, old age, and stress. Most of these factors have proved relevant to some arthritis sufferers. I believe the occurrence of the symptoms of arthritis, or any type of arthritic disease, is the result of an accumulation of stresses that eventually causes joint, bone, and muscle degeneration.

  How arthritis develops.

  Why arthritis develops

  The likely factors that lead to the development of this painful condition are:

  Poor lubrication of the joints. In between joints is a substance called synovial fluid. Good nutrition is needed to make sure that the synovial fluid stays fluid and able to lubricate. Cartilage and synovial fluid contain mucopolysaccharides, which can be provided by certain foods.

  Hormonal imbalance. Hormones control the calcium balance in the body. If the calcium balance is out of control, the bones and joints can become porous and subject to wear and tear, and calcium can be deposited in the wrong place, resulting in arthritic “spurs.” The fault is not so much calcium intake, but the loss of calcium balance in the body. A lack of exercise; too much tea, coffee, alcohol, or chocolate; exposure to toxic metals like lead; excessive stress; or underlying blood sugar or thyroid imbalances can all upset calcium control. While calcium control can be worse after menopause, probably owing to the loss of estrogen, too much estrogen also makes arthritis worse. It is all a question of balance. Another hormone, insulin, stimulates the synthesis of mucopolysaccharides, from which cartilage is made. People with underactive thyroid glands are particularly susceptible to arthritis.

  Allergies and sensitivities. Almost everyone who suffers from rheumatoid arthritis and many people who have osteoarthritis have food and chemical allergies or sensitivities that make their symptoms flare up. The most common food allergies are to wheat and dairy products. Chemical and environmental sensitivities can include gas and exhaust fumes. These are well worth strictly avoiding for one month so you can see whether they contribute to the problem.

  Free radicals. In all inflamed joints, a battle is taking place, with the body trying to deal with the damage. One of the key weapons of war in the body is free radicals (see this page). If the immune system is not working properly, as in rheumatoid arthritis, it will produce too many free radicals, which can damage tissue around the joint. A low intake of antioxidant nutrients can make arthritis worse.

  Infections. Any infection, be it viral or bacterial, weakens the immune system, which controls inflammation. But some viruses and bacteria particularly affect the joints by lodging in them and recurring when immune defenses are low. Often the immune system can harm surrounding tissue in an attempt to fight an infection, like an army that obliterates its own country in trying to get rid of an invader. Building up your immune defenses through optimum nutrition is the natural solution.

  High homocysteine. Several studies have found a link between high homocysteine levels and both osteoporosis and arthritis. It’s well worth checking your level and lowering it by supplementing specific nutrients (see chapter 16).

  Bone strain and deformities. Any damage or strain, so often caused by bad posture, increases the risk of developing arthritis. A yearly checkup with an osteopath or chiropractor, plus regular exercise that helps increase joint suppleness and strength, is the best prevention. Once arthritis has set in, special exercises help reduce pain and stiffness.

  State of mind. Research at the Arthritis and Rheumatism Foundation and at the University of Southern California Medical School has shown a link between arthritis and emotional stress. “Hidden anger, fear, or worry often accompanies the beginning of arthritis,” says Dr. Austin from USC.

  Poor diet. Most arthritics have a history of poor diet, which paves the way for many of the above risk factors. Too much refined sugar, too many stimulants, too much fat, and too much protein are all strongly associated with arthritic problems. A lack of any of a large number of vital vitamins, minerals, and essential fatty acids could, in itself, precipitate joint problems.

  Nature’s painkillers

  Whatever the cause, once arthritis develops there is usually inflammation, causing pain, redness, and swelling. Anti-inflammatory drugs fall into two main categories—cortisone-based and nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs account for more adverse drug reactions and deaths than any other class of drug.

  The good news is that there are highly effective alternatives.

  OMEGA-3 FISH OILS

  One of the most popular alternatives is fish oils, which can be converted in the body to anti-inflammatory prostaglandins called PG3s. These counteract the inflammatory PG2s. Research has conclusively shown that fish-oil supplementation can reduce the inflammation of arthritis.31 An effective amount is the equivalent of 1,000 mg of EPA and DHA a day, which means two or three capsules. Cod liver oil, the richest source of omega-3 fats, has also been shown to reduce the pain and inflammation of arthritis.

  A recent study giving osteoarthritis patients scheduled for knee replacement surgery cod liver oil is a case in point. Half the thirty-one patients were given two daily capsules of 1,000 mg extra-high-strength cod liver oil, rich in omega-3 fats (DHA and EPA), and the other half were given placebo oil capsules containing no omega-3 fats for ten to twelve weeks. A total of 86 percent of preoperative patients with arthritis who took the cod liver oil capsules had absent or markedly reduced levels of enzymes that cause cartilage damage, as opposed to 26 percent of those given a control oil. Results also showed a reduction in the inflammatory markers that cause joint pain among those who took the cod liver oil.32

  NATURAL PAINKILLERS

  Turmeric, boswellia, ashwagandha, hop extract, and ginger all help reduce the overproduction of leukotrienes that cause pain and inflammation.

  The bright yellow pigment of the spice turmeric contains the active compound curcumin, which has a variety of powerful anti-inflammatory actions—trials in which it was given to arthritic patients showed it to be similarly effective to the anti-inflammatory drugs, without the side effects. You need about 500 mg, one to three times a day.

  Frankincense may be the ultimate gift for an arthritic friend. Its botanical name is Boswellia serrata, and it is also known as Indian frankincense; it is proving to be a very powerful natural anti-inflammatory agent, without the side effects of current drugs. In one study where patients initially received boswellic acid, the active ingredient within the plant, and then later a placebo, arthritic symptoms were significantly reduced, but then returned with a vengeance when the treatment was switched over to placebo.33 Boswellic acid appears to reduce joint swelling, restores and improves blood supply to inflamed joints, provides pain relief, increases mobility, improves morning stiffness, and prevents or slows the breakdown of the components of cartilage. Preparations are available in tablet and cream form—the ideal dose is 200 to 400 mg, one to three times a day; the creams are especially useful in the treatment of localized inflammation.

  Ashwagandha is a promising natural remedy that has been used for hundreds of years as part of Ayurvedic medicine in India. The active ingredients of this powerful natural anti-inflammatory herb are “withanolides.” In animal studies, ashwagandha has proven highly effective against arthritis. In one study, animals with arthritis were given ashwagandha, hydrocortisone, or placebo. While hydrocortisone produced a 44 percent reduction in symptoms, ashwagandha produced an 89 percent reduction, making it substantially more effective than cortisone.34 Try 1,000 mg a day of the root, providing 1.5 percent withanolides.

  One of the most effective natural painkillers of all is an extract from hops called IsoOxygene. It works just as well as painkilling drugs but without the associated gut problems. You need about 1,500 mg a day
.

  Ginger is also anti-inflammatory, as well as rich in antioxidants. In one study, supplementing ginger (500 to 2000 mg a day) reduced pain and swelling in three-quarters of those with arthritis. Alternatively, eat a ½-inch (1 cm) slice of fresh ginger each day.35

  INFLAMMATION REDUCERS

  Antioxidant nutrients help reduce inflammation, so keep eating those berries and supplementing an antioxidant formula. However, there are some exciting plant extracts that have very powerful antioxidant and anti-inflammatory effects. One of these is an extract from olives called hydroxytyrosol. This is what is called a polyphenol. Other plant foods containing polyphenols include green tea, grape skins, and onions, all of which contain quercetin, but none is as powerful as this extract of olives. Compared with that of vitamin C, its ORAC rating, a measure of antioxidant power, is more than ten times higher. Try 400 mg a day.

  GLUCOSAMINE AND MSM: THE JOINT BUILDERS

  Glucosamine is an essential part of the building material for joints and the cellular “glue” that holds the entire body together, although joint cartilage contains the highest concentration of glucosamine.36 The mechanism by which glucosamine appears to stop or reverse joint degeneration is by providing the body with the materials needed to build and repair cartilage.