I heard about a study that found that calcium increased heart disease risk. Should I not take calcium supplements for my bones?

Discovery 13/365Creative Commons License  Yours is a very good question. Last year a  review of data from a large study found a slight elevated risk for heart disease and stroke in women who took supplements of calcium with or without vitamin D. What are we to do with this information?

First off, the best place to get all your nutrients is from food. Anyone worth their weight in nutrition credentials will tell you to go to milk and other calcium-rich foods. The reality is, few women drink 3 to 4 glasses of milk a day and their diets are far too low in this mineral. If you aren’t getting enough calcium from dietary sources, you risk the crippling disease of osteoporosis and possibly colon cancer and high blood pressure.

Second, nutrition is not a black-and-white science. Studies flip flop on topics, so you must look at where the weight of the evidence lies. Each study is like a thread in a tapestry. What does the tapestry say. In this case, there are many more studies showing calcium is safe and important for bone health and only a few that suggest it might slightly elevated heart disease risk.

The bottom line:  On the days when you don’t consume at least 3 calcium-rich foods in the daily diet, take a moderate-dose calcium (preferably with magnesium) supplement.  You only need to fill in the gaps between recommended intake and your dietary intake, not supply the entire 1,200 milligrams of calcium from a pill. I recommend one that supplies these two minerals in a 2:1 ratio, or about 500 milligrams calcium and 250 milligrams magnesium.

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Everyone tells me to eat my “greens.” Can you explain why they are so important?

Dark greens, like spinach, kale, collards, and chard, are some of the most mood and energy-enhancing foods on the planet. Calorie for calorie, you get more vitamins, minerals, phytonutrients and fiber than almost any other food. Greens clean arteries, protect brain cells from aging and depression, and improve blood flow to all body parts, thus lowering the risk for heart disease, cancer, vision loss, stroke, dementia, high blood pressure, wrinkling and skin cancer, erectile dysfunction, and loss of libido. They are rich in antioxidants, potassium, B vitamins, vitamin C, magnesium, calcium, zinc, iron, chlorophyll, and a host of phytonutrients from carotenoids to polyphenols and betaine. You honestly can’t get to your optimal vitality without greens.

How much do you need? Aim for at least 2 servings a day of the darkest greens you can find. A serving is 1 cup raw and 1/2 cup cooked. Include spinach or baby greens in salads and sandwiches. Steam them and add to mashed potatoes, lasagna, soups, and stews. Saute them with garlic in olive oil.

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Can making a few changes in my diet really make that much of a difference in my risk for heart disease?

Absolutely! Studies, including ones from the University of Toronto, have found that after one month of eating healthfully, people lowered their cholesterol by 29%, which is what you would expect from taking statin medications! While the statin medications come with a load of potential side effects, from nausea and headaches to liver failure, the only side effect of eating a heart-healthy diet is you may lose a few pounds and live longer.

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I hear that coconut oil can help me lose weight and lower heart disease. Is this true?

A little coconut won’t hurt, but don’t be fooled by recent diet books that tout coconut oil as the secret ingredient for weight loss and health. Unlike most nuts that contain heart-healthy fats, the main fat in coconut is saturated fat (at ~ 92% saturated fat, coconut oil makes butter and lard look like health food!). However, the main saturated fat in coconut oil is lauric acid, which is a “medium-chain triglyceride” or MCT. Unlike the longer saturated fats in dairy products and meat, MCTs are shorter, more quickly absorbed, and likely to be burned for energy, rather than stored as fat. Numerous studies show that MCTs increase metabolism, aid in weight loss, and lower body fat. Lauric acid also is mildly effective in protecting against liver damage, possibly aiding thyroid function, and providing some anti-inflammatory benefits. That’s the argument to justify drinking coconut-laden smoothies with 93% fat calories – hey, it’s mostly MCTs, so you’ll drop pounds just downing the shake!

Like the old adage says, “If it sounds to good to be true, it probably is.” There are no studies on coconut and weight loss (or even other health links like Alzheimer’s disease), only mixed evidence using purified MCTs. Even then, these fats appear useful mainly for hospitalized patients requiring tube feedings. For the healthy person who wants to drop a few pounds or even avoid weight gain, the research is scanty at best. And, get this – you must consume half your calories as MCTs to see results, which is a lot more than you could realistically get from coconuts and also could cause side effects, including nerve damage and intestinal cramping. In short, I don’t know of any good data on long-term weight changes using food, including coconut, as a source of MCTs. If people lose weight with coconut, it’s because they cut calories, not because they sprinkled coconut on their chicken.

OK, so coconut oil isn’t the Promised Land for weight loss, but is it good for your health? The proponents of coconut say we’ve been duped into thinking that the saturated fats in tropical oils are bad for us, pointing out that we’ve “…drastically reduced saturated fats…[which] has not solved the nation’s health problems.” They say lauric acid in coconut oil lowers, not raises, heart-disease risk, as proven by the low rates of heart disease in coconut-eating cultures such as India.

First, saturated fats, along with trans fats, are major contributors to heart disease, it’s just that few people follow the dietary advice to cut back. Second, while cultures where people eat coconut-rich diets sometimes do have a lower incidence of disease, there is no proof it is because of coconut. It could be that these people are at low risk because they are lean, physically active, and eat traditional diets rich in fruits, vegetables, and other real foods. In contrast, adding coconut oil to the fat- and sugar-laden American diet is like pouring kerosine on a blazing fire of obesity.

The evidence linking coconut oil to heart disease is contradictory, but points sharply in the direction of caution. Some studies show lauric acid might improve the ratio of bad cholesterol (LDL) to good cholesterol (HDL), thus lowering heart-disease risk. Even then, coconut oil is no where near as beneficial as switching from butter to olive oil. Coconut oil should be judged on it’s entire fat content, not just it’s lauric acid. Coconut oil also contains myristic acid, a fat that dramatically raises blood cholesterol levels. Keep in mind, decades of studies show that tropical oils, including coconut oil, actually raise, not lower, heart disease risk, which is why they were removed from processed foods in the first place. Even researchers from countries, such as India, recommend a decrease in coconut oil consumption to reduce their rising heart-disease rates. Based on the research and information we have to date, I can’t imagine returning to coconut oil is a good. In short, if coconut has any effect on metabolism it is modest compared to its potential to raise your risk for heart disease.

Don’t get me wrong. Coconut has redeeming qualities. Virgin coconut oil (made by pressing coconut meat with minimal heat to remove the oil) has some antioxidant-rich vitamin E and phytochemicals called polyphenols. Coconut flakes also have some fiber. Small amounts added now and then also add flavor and enjoyment to a meal. Until we know more about the long-term health effects of this fat, it’s best to err on the side of caution – if you use coconut milk in cooking, grab the “light” version, which has 70% less fat and 65% fewer calories. Then use it sparingly.

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What bottled green tea do you recommend?

None. Make your own. Green tea has antioxidant compounds with fancy names like polyphenols that lower cancer and heart disease risk. These compounds also might lower skin cancer risk and even help you look younger. But, those health-boosting polyphenols don’t make it into bottled teas in appreciable amounts, if at all. What does make it into the bottle is sugar. Many of these teas have the calorie equivalent of a side order of hashbrowns. And, because they are liquid calories, they don’t fill us up, so it is easy to over-consume calories, which means weight gain. Save your money and brew your own green tea at home, where you are assured of getting the greatest concentration of all the antioxidants and polyphenols that research shows are good for us. You’ll also save yourself money that can be used to buy more antioxidant-rich produce!

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