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Once again, a study finds that foods are superior to supplements (here calcium supplements). It appears that eating foods rich in calcium has protective effects against kidney stones, but taking calcium supplements may result in kidney stone growth.

On the other hand, vitamin D may prevent kidney stone formation. Reviewing studies over the past few years, it seems that vitamin D (the sunshine vitamin) is the one supplement with positive effects.

From Science Daily: Calcium supplements may increase the risk of kidney stone recurrence

Calcium supplements may increase the risk of kidney stone recurrence, according to a new study.

While eating foods rich in calcium has protective effects against kidney stones, the effect of supplementation with calcium and vitamin D on the risk of kidney stone formation remains unclear. To investigate, Christopher Loftus, MD candidate (Cleveland Clinic Lerner College of Medicine) and his colleagues reviewed the 24-hour urine collections and CT imaging scans from patients at their institution who had a history of kidney stones.

They identified 6050 patients with a history of kidney stones by imaging scans, 2061 of whom had 24-hour urine collections before and after starting supplementation. A total of 1486 patients were supplemented with calcium, 417 with vitamin D only, and 158 with no supplementation.

Patients who took calcium supplements had lower total calcium and oxalate (which are components of kidney stones) in their urine while blood levels were unaffected. However, these patients also had a faster rate of kidney stone growth suggesting that the mechanism of calcium supplementation on stone formation may not be straightforward. Vitamin D supplementation also decreased urinary calcium excretion as well as stone growth, suggesting that it may help prevent the risk of stone formation.

"While taking supplemental calcium has associated positive effects, these results suggest that supplemental, as compared with dietary, calcium may worsen stone disease for patients who are known to form kidney stones," said Loftus.

A new U.S. Preventive Services Task Force (USPSTF) recommendation says that while they recommend screening for high blood pressure in adults aged 18 years or older, they also recommend that high blood pressure levels should generally be confirmed with home or ambulatory blood pressure monitoring before starting treatment for hypertension. This is because many factors can influence readings in an office, including "white coat hypertension" - which is an elevated reading from the stress of being in the doctor's office. The USPSTF evaluates, reviews, and makes evidence-based recommendations about clinical preventive services such as screenings, counseling services, and preventive medications. From Medical Xpress:

Confirm high blood pressure outside doctor's office, US task force says

High blood pressure levels should generally be confirmed with home or ambulatory blood pressure monitoring before starting treatment for hypertension, a new U.S. Preventive Services Task Force (USPSTF) recommendation says.

Many factors can affect blood pressure readings, such as stress, physical activity and caffeine or nicotine, the USPSTF said. And, some people experience "white-coat hypertension"—an increase in blood pressure at the doctor's office from stress—when having their blood pressure taken. All of these factors can make it hard to tell if someone really has high blood pressure, the researchers said.

That's why the Task Force recommends confirming a diagnosis of high blood pressure, or hypertension, before starting treatment, unless someone has very high blood pressure that needs to be treated right away."For most patients, elevated blood pressure readings in the doctor's office should be confirmed outside the doctor's office before starting treatment," said Task Force vice-chair Dr. Kirsten Bibbins-Domingo.

Blood pressure levels can be confirmed with ambulatory blood pressure monitoring. Your doctor will provide a small, portable device that automatically measures your blood pressure every 20 to 30 minutes over 12 to 48 hours. If this method isn't available, people can take their blood pressure at different times throughout the day using home blood pressure monitoring, the USPSTF said. Ambulatory blood pressure monitoring is the first choice for confirming a diagnosis of high blood pressure, the Task Force said. But, when not available, home monitors are an acceptable alternative.

Home blood pressure monitoring devices can cost from less than $20 to $100 or more, according to Consumers Union. Devices that use upper arm readings—rather than finger or wrist—are considered more accurate, the American Heart Association (AHA) says. But, it's important that the cuff that wraps around your arm fits properly, the AHA advises.

The dangers of sustained high blood pressure include an increased risk for heart attack, stroke, kidney disease and heart failure, the USPSTF said. High blood pressure is a leading cause of death in the United States, particularly among older Americans, Bibbins-Domingo said.

A new study that tracked people more than 20 years found that a diet high in carotenoids - found in brightly colored fruits and vegetables (such as carrots, orange peppers, spinach, broccoli) - is linked to lower levels of macular degenaration (an age linked vision ailment).

Note that the link is found with real foods and not supplements (the researchers did not look at supplements). From Medical Xpress:

Carrots do help aging eyes, study shows

Your parents may have told you, "Eat your carrots, they're good for your eyes," and a new study suggests they were on to something. Pigments called carotenoids—which give red or orange hues to carrots, sweet potatoes and orange peppers, or deep greens to produce like spinach, broccoli and kale—may help ward off the age-linked vision ailment known as macular degeneration, researchers said.

Age-related macular degeneration (AMD) is one of the most common causes of vision loss, especially in the elderly. It affects the macula, the center part of the retina, and can lead to declines in sharp central vision and even blindness, experts say. 

Scientists have already linked a variety of factors to the condition including genetics, smoking and nutrition, said Bernstein, who was not involved in the new study. Prior research has produced mixed findings about links between carotenoids and macular degeneration, the researchers said. 

In the new study, Wu's team looked at data from health surveys that tracked people aged 50 and older—more than 63,000 women and almost 39,000 men—from 1984 or 1986 until 2010. Participants were all nurses and other health professionals. Overall, about 2.5 percent of study participants developed either intermediate or advanced forms of the eye condition during the years of the study.

Wu's team found that people who consumed the very highest levels of carotenoids known as lutein and zeaxanthin had a 40 percent lower risk of the advanced form of AMD compared to those who ate the veryleast. Other carotenoids, including beta cryptoxanthin, alpha carotene and beta carotene, may also play protective roles," Wu added. People who consumed the very highest amount of these carotenoids—found in foods such as carrots and sweet potatohad a 25 to 35 percent lower risk of the advanced form of the illness, the findings showed.

Researchers did not find any link between the carotenoids and the intermediate form of macular degeneration, however. Lutein is found in eggs and dark leafy vegetables including broccoli, kale and spinach, Bernstein said. Zeaxanthin is harder to find in the diet, he said, but you can get it from corn, orange peppers and goji berries. Wu noted that both lutein and zeaxanthin concentrate in the macula, where they are thought to protect it from damage from oxygen and light.

Bernstein cautioned that the study has some weaknesses. It's based on people's recollections of their diets, he said, and doesn't examine the levels of the carotenoids that actually made it into their bodies and eyes. Still, he praised the research.... However, he said, a diet high in fruits and vegetables is important, especially colorful vegetables. Consume several servings a day, he advised.

This study, even though done on mice, reinforces previous research that taking antioxidant supplements are linked to higher rates of cancer or the spread of cancer (metastases). Here it is linked to the spread of metastatic skin cancer. The researchers say that the overall conclusion from the various studies is that antioxidants protect healthy cells from free radicals that can turn them into malignancies, but may also protect a tumor once it has developed. They also suggest that suntan lotions and skin lotions containing vitamin E and beta-carotene may have the same negative effect and are now studying that possibility. However, note that many, many studies find that eating foods does NOT find negative effects, but only beneficial ones for health. The October 5, 2015 post also discussed why supplements containing large doses of antioxidants (such as beta-carotene) don't work, and can even cause harm. Bottom line: Eat fruits and vegetables daily for numerous health benefits, but skip the antioxidant supplements. From Science Daily:

Antioxidants cause malignant melanoma to metastasize faster

Antioxidants can double the rate of melanoma metastasis in mice, new research shows. The results reinforce previous findings that antioxidants hasten the progression of lung cancer. People with cancer or an elevated risk of developing the disease should avoid nutritional supplements that contain antioxidants, the researchers say.

Researchers at Sahlgrenska Academy, University of Gothenburg, demonstrated in January 2014 that antioxidants hastened and aggravated the progression of lung cancer. Mice that were given antioxidants developed additional and more aggressive tumors. Experiments on human lung cancer cells confirmed the results. Given well-established evidence that free radicals can cause cancer, the research community had simply assumed that antioxidants, which destroy them, provide protection against the disease. Found in many nutritional supplements, antioxidants are widely marketed as a means of preventing cancer. Because the lung cancer studies called the collective wisdom into question, they attracted a great deal of attention.

The follow-up studies at Sahlgrenska Academy have now found that antioxidants double the rate of metastasis in malignant melanoma, the most perilous type of skin cancer. Science Translational Medicine published the findings on October 7. "As opposed to the lung cancer studies, the primary melanoma tumor was not affected," Professor Bergö says. "But the antioxidant boosted the ability of the tumor cells to metastasize, an even more serious problem because metastasis is the cause of death in the case of melanoma. The primary tumor is not dangerous per se and is usually removed."

Experiments on cell cultures from patients with malignant melanoma confirmed the new results. "We have demonstrated that antioxidants promote the progression of cancer in at least two different ways," Professor Bergö says. The overall conclusion from the various studies is that antioxidants protect healthy cells from free radicals that can turn them into malignancies but may also protect a tumor once it has developed.

Avoid supplements: Taking nutritional supplements containing antioxidants may unintentionally hasten the progression of a small tumor or premalignant lesion, neither of which is possible to detect. "Previous research at Sahlgrenska Academy has indicated that cancer patients are particularly prone to take supplements containing antioxidants," Dr. Bergö says. Our current research combined with information from large clinical trials with antioxidants suggests that people who have been recently diagnosed with cancer should avoid such supplements."

The role of antioxidants is particularly relevant in the case of melanoma, not only because melanoma cells are known to be sensitive to free radicals but because the cells can be exposed to antioxidants by non-dietary means as well. "Skin and suntan lotions sometimes contain beta carotene or vitamin E, both of which could potentially affect malignant melanoma cells in the same way as antioxidants in nutritional supplements," Professor Bergö says. How antioxidants in lotions affect the course of malignant melanoma is currently being explored. "We are testing whether antioxidants applied directly to malignant melanoma cells in mice hasten the progression of cancer in the same way as their dietary counterparts," Professor Bergö says. 

 More and more studies are finding negative health effects from hormone disrupting chemicals (which we are exposed to every single day, and subsequently which are in all of us), such as parabens, phthalates, Bisphenol-A (BPA), and chemical substitutes for BPA such as Bisphenol-S (BPS) and BPF.  The last post had some recent studies that looked at health effects of hormone disrupting chemicals. The following article points out some of the many difficulties in developing packaging that is safe and doesn't leach endocrine disrupting chemicals or even other chemicals.

We generally focus on hormone disrupting chemicals in plastic bottles or metal cans (which their epoxy liners), but other parts of packaging may (or may not) also leach chemicals. Some leaching may occur with the adhesives used to seal foil pouches, and the polypropylene inner layers also may leach stabilizers. Glass jars are OK, but jar lids may be equipped with BPA-based epoxy liners and/or gaskets that leach plasticizers. Greaseproof wrappers may leach poly- and perfluorinated compounds used to make some packaging greaseproof (may occur if packaging is from India and China - because it is legal to import into USA and use).  Some ceramic kitchenware - the glazes used in artisanal pottery and older mass produced ceramics may leach toxic metals, especially lead. There can even be "offset migration" which occurs when the printed outer surface of food packaging transfers chemicals to the inner food-contact surface.  Whew...

Bottom line: Even BPA alternatives (labeled BPA-free) should be viewed as the same as BPA (as endocrine disruptors) - in other words, currently there are no good BPA substitutes. Read labels and try to minimize plastics in personal care products (e.g., lotion, fragrances) and your food if possible (e.g., choose glass, stainless steel, wax paper, aluminum foil). This is especially important during pregnancy.  Don't microwave food in a plastic dish or container, or covered with plastic wrap. Eat fresh foods and try to avoid soda cans and other packaged, processed foods, especially in plastic containers or metal cans. From Environmental Health Perspectives: A Hard Nut to Crack: Reducing Chemical Migration in Food-Contact Materials

When we buy food, we’re often buying packaging, too. From cherries to Cheez-It® crackers, modern foods are processed, transported, stored, and sold in specialized materials that account, on average, for half the cost of the item, according to Joseph Hotchkiss, a professor in Michigan State University’s School of Packaging. Consumer-level food packaging serves a wide range of functions, such as providing product information, preventing spoilage, and protecting food during the journey from production to retail to pantry, fridge, or freezer. That’s why food producers lavish so much time and money on it.

But what happens when these valuable and painstakingly engineered containers leach chemicals and other compounds into the food and drink they’re designed to protect? Such contamination is nearly ubiquitous; it happens every day, everywhere packaged food is found, with all common types of packaging, including glass, metal, paper, and plastic. Even as awareness of the issue grows, large-scale solutions that are scientifically and financially viable remain out of reach. The challenges in reaching them are many.  ...continue reading "Chemicals Migrate From Containers to Food"

More and more studies are finding negative health effects from hormone disrupting chemicals (which we are exposed to every single day, and subsequently which are in all of us), such as parabens, phthalates, Bisphenol-A (BPA), and chemical substitutes for BPA such as Bisphenol-S (BPS) and BPF. The following are a few recent studies and one article from my files. Also check out the other endocrine disrupting chemical studies I've posted (SEARCH: 'endocrine disruptors', and 'phthalates').

Bottom line: Read labels and try to minimize plastics in personal care products (e.g., lotion) and your food if possible (e.g., choose glass, stainless steel, wax paper, aluminum foil). This is especially important during pregnancy.  Even BPA alternatives (labeled BPA-free) should be viewed as the same as BPA - as endocrine disruptors. In other words, currently there are no good BPA substitutes. Don't microwave food in a plastic dish or container, or covered with plastic wrap. Eat fresh foods rather than packaged, processed foods. From Newsweek:

BPA Is Fine, If You Ignore Most Studies About It

Bisphenol-A (BPA) is either a harmless chemical that’s great for making plastic or one of modern society’s more dangerous problems. Depends whom you ask. BPA is in many types of plastics and the epoxy resins that line most aluminum cans, as well as thermal papers like receipts. It is an endocrine disruptor that mimics estrogen, a hormone especially important in sexual development, and the fact that it’s all over the place worries many people. Newsweek spoke with about 20 scientists, leaders in the field of BPA research, and the majority say it is likely (though not certain) that the chemical plays a role in a litany of health concerns: obesity, diabetes, problems with fertility and reproductive organs, susceptibility to various cancers and cognitive/behavioral deficits like ADHD ...continue reading "More Negative News About Hormone Disrupting Chemicals"

Years ago people with asthma were told to limit their exercise, for fear it would set off an asthma attack. Now research suggests that the best thing you can do for asthma (to control symptoms) is to get regular exercise year round - here 30 minutes per day, whether walking, biking, or other moderate activities.

From Science Daily: Just 30 minutes a day: Regular exercise relieves asthma symptoms

Millions of people suffer from asthma. Many report having poor control of their symptoms. Fortunately, new research shows there is a simple antidote: 30 minutes of exercise a day, year-round.

In a study recently published in BMJ Open Respiratory Research, experts from Concordia University, the Hôpital du Sacré-Coeur de Montréal and several other institutions analyzed the exercise habits of 643 participants who had been diagnosed with asthma. Results were overwhelmingly clear: those who engaged in optimal levels of physical activity on a regular basis were nearly two-and-a-half times more likely to have good control of their symptoms, compared with those who did no exercise. The workout doesn't have to be strenuous...."Just 30 minutes a day of walking, riding a bike, doing yoga -- anything active, really -- can result in significant reduction of asthma symptoms."

Traditionally, people with the condition have been discouraged from exercising because of a belief that it triggers shortness of breath and attacks. Bacon explains that simple precautionary measures can be taken to avoid the discomforts that can be caused by physical activity. "The issue of exercise-induced bronchospasm is real -- but if you use your releaver medication, blue puffer, before you exercise, and then take the time to cool down afterwards, you should be okay," he says. "Even if you have asthma, there's no good reason not to get out there and exercise."

That's a message Bacon hopes resonates. Within his sample group of 643 individuals, a whopping 245 reported doing no physical activity. Only 100 said they engaged in the optimal 30 minutes a day...."We need to keep in mind that doing something is better than nothing, and doing more is better than less. Even the smallest amount of activity is beneficial."...."Our study shows that those who were able to engage in physical activity on a regular basis year-round benefit most," says Bacon. If necessary, he suggests finding an indoor place to move, whether it's the gym, a staircase or a shopping mall.

 There has been tremendous concern in recent years over pathogenic bacteria (such as Salmonella and Escherichia coli) found on raw fruits and vegetables. But what about nonpathogenic bacteria? Aren't some of the benefits of eating raw fruits and vegetables the microbes found on them? What actually is on them?

The following research using modern genetic analysis (16 S rRNA gene pyrosequencing) is from 2013, but very informative and the only study that I could find of its kind. The results suggest that humans are exposed to substantially different bacteria depending on the types of fresh produce they consume, with differences between conventionally and organically farmed varieties contributing to this variation.

While each of the 11 produce types studies harbored different microbial communities, the most common (abundant) across all samples were: Enterobacteriaceae [30% (mean)], Bacillaceae (4.6%), and Oxalobacteraceae (4.0%). Earlier studies also suggested that non-pathogenic microbes may interact with and inhibit microbial pathogens found on produce surfaces. Bottom line: eat a variety of raw fruits and vegetables to get exposed to a variety of non pathogenic microbes.

From Science Daily: Diverse bacteria on fresh fruits, vegetables vary with produce type, farming practices

Fresh fruit and vegetables carry an abundance of bacteria on their surfaces, not all of which cause disease. In the first study to assess the variety of these non-pathogenic bacteria, scientists report that these surface bacteria vary depending on the type of produce and cultivation practices. The results are published March 27 in the open access journal PLOS ONE by Jonathan Leff and Noah Fierer at the University of Colorado, Boulder.

The study focused on eleven produce types that are often consumed raw, and found that certain species like spinach, tomatoes and strawberries have similar surface bacteria, with the majority of these microbes belonging to one family. Fruit like apples, peaches and grapes have more variable surface bacterial communities from three or four different groups. The authors also found differences in surface bacteria between produce grown using different farming practices.

The authors suggest several factors that may contribute to the differences they observed, including farm locations, storage temperature or time, and transport conditions. These surface bacteria on produce can impact the rate at which food spoils, and may be the source of typical microbes on kitchen surfaces. Previous studies have shown that although such microbes don't necessarily cause disease, they may still interact with, and perhaps inhibit the growth of disease-causing microbes. The results of this new research suggest that people may be exposed to substantially different bacteria depending on the types of produce they consume.

Excerpts of the actual study from PLoS One:  Bacterial Communities Associated with the Surfaces of Fresh Fruits and Vegetables

Fresh fruits and vegetables can harbor large and diverse populations of bacteria. However, most of the work on produce-associated bacteria has focused on a relatively small number of pathogenic bacteria....Our results demonstrated that the fruits and vegetables harbored diverse bacterial communities, and the communities on each produce type were significantly distinct from one another. However, certain produce types (i.e., sprouts, spinach, lettuce, tomatoes, peppers, and strawberries) tended to share more similar communities as they all had high relative abundances of taxa belonging to the family Enterobacteriaceae when compared to the other produce types (i.e., apples, peaches, grapes, and mushrooms) which were dominated by taxa belonging to the Actinobacteria, Bacteroidetes, Firmicutes, and Proteobacteria phyla. ...Taken together, our results suggest that humans are exposed to substantially different bacteria depending on the types of fresh produce they consume with differences between conventionally and organically farmed varieties contributing to this variation.

Fresh produce, including apples, grapes, lettuce, peaches, peppers, spinach, sprouts, and tomatoes, are known to harbor large bacterial populations [1][7], but we are only just beginning to explore the diversity of these produce-associated communities. We do know that important human pathogens can be associated with produce (e.g., L. monocytogenes, E. coli, Salmonella), and since fresh produce is often consumed raw, such pathogens can cause widespread disease outbreaks [8][11]. In addition to directly causing disease, those microbes found in produce may have other, less direct, impacts on human health. Exposure to non-pathogenic microbes associated with plants may influence the development of allergies [12],and the consumption of raw produce may represent an important means by which new lineages of commensal bacteria are introduced into the human gastrointestinal system. 

Although variable, taxonomic richness levels differed among the eleven produce types with richness being highest on peaches, alfalfa sprouts, apples, peppers, and mushrooms and lowest on bean sprouts and strawberries (Fig. 1). Bacterial communities were highly diverse regardless of the produce type with between 17 and 161 families being represented on the surfaces of each produce type. However, the majority of these families were rare; on average, only 3 to 13 families were represented by at least two sequences per produce type.

Furthermore, pairwise tests revealed that the community composition on the surface of each produce type differed significantly from one another. Still, certain produce types shared more similar community structure than others. On average, tree fruits (apples and peaches) tended to share communities that were more similar in composition than they were to those on other produce types, and produce typically grown closer to the soil surface (spinach, lettuce, tomatoes, and peppers) shared communities relatively similar in composition. Surface bacterial communities on grapes and mushrooms were each strongly dissimilar from the other produce types studied.

An article that discusses why supplements containing large doses of antioxidants, or beta-carotene, or even vitamin megadoses  doesn't work, and can even cause harm, while eating actual foods such as fruits and vegetables has many health benefits. This is what a number of the studies I've been posting also found (especially with health benefits from eating fish and not from fish oil). go ahead and throw out the megadose supplements, and instead eat lots of fruits and vegetables. Remember fruits and vegetables contain a complex mix of nutrients and feed our microbial communities, as well as having microbes on them. From Medical Xpress:

Forget the antioxidant pills; just stick with veggies

Why just stick to eating fruits and veggies when you can get an extra boost from supplements that put good things like antioxidants into a handy pill? And that seems like it should be a good idea. If the antioxidants that occur naturally in our food, like broccoli and carrots, are good for us, a supplement with the same thing must also be good. But that's not quite true.

Antioxidants are touted as protectors of our health because they eliminate free-radicals that damage molecules in cells and tissues by grabbing electrons from them, making those molecules, in turn, unstable....On this basis, a group of scientists proposed in 1981 the creation of a nutritional supplement to fight free-radicals. They reasoned that since many observational epidemiological studies had shown that people who eat lots of vegetables are at lower risk of colon cancer, heart disease and many other bad conditions, then the "active" ingredient should be identified and put into a pill. They thought that it must be beta-carotene, which helps make carrots orange, because it's an antioxidant.

But in the late 1980s, two intervention trials, one in Seattle and the other in Finland, started....For the Seattle trial, approximately 18,000 men and women were randomized in 1988 to receive either a tablet containing beta-carotene or a tablet containing no active ingredient, which is the famous placebo. The plan was to follow the men and women for 10 years; the researchers hypothesized they would observe a lower lung cancer risk in the beta-carotene tablet group, hopefully much lower. But the opposite happened and the trial had to be stopped early because the beta-carotene group suffered significantly more cases of lung cancer than the placebo group. The same thing was seen in the Finland trial. Importantly, the amount of beta-carotene in the tablet was much higher than occurs naturally in the body in both trials.   ...continue reading "Forget the Pills, Eat the Vegetables Instead"

Having raised two energetic sons, I am more and more distressed over how "academic" and serious kindergarten and first grade has become. It seems that recess and creative play times have basically ended, with young children having to sit still in their seats for hours and hours on end doing mindlessly boring worksheets. Numerous standardized tests. And this is when they're only 5 and 6 years old. Where is the joy of learning? Where is the time for creativity, intellectual curiosity, imagination, invention, and "learning and working things out by oneself"? Much of this occurs during play - yes, play.

There is research showing that children, especially active boys, need time to run around and blow off energy, as well as that movement and fidgeting helps active children learn. Instead more and more children are given a diagnosis of ADHD when they have trouble sitting still for hours in today's American schools, and may be given medications for years. Thus I really liked this article about kindergarten in Finland, where play and joy of learning are considered very important for healthy development and eventual academic success. From The Atlantic:

The Joyful, Illiterate Kindergartners of Finland

“The changes to kindergarten make me sick,” a veteran teacher in Arkansas recently admitted to me. “Think about what you did in first grade—that’s what my 5-year-old babies are expected to do.”....the kindergarten she described in her email: three and a half hours of daily literacy instruction, an hour and a half of daily math instruction, 20 minutes of daily “physical activity time” (officially banned from being called “recess”) and two 56-question standardized tests in literacy and math—on the fourth week of school.

A working paper, “Is Kindergarten the New First Grade?,” confirms what many experts have suspected for years: The American kindergarten experience has become much more academic—and at the expense of play.... Researchers at the University of Virginia, led by the education-policy researcher Daphna Bassok, analyzed survey responses from American kindergarten teachers between 1998 and 2010....major shifts over this period towards a heightened focus on academics, and particularly a heightened focus on literacy, and within literacy, a focus on more advanced skills than what had been taught before.”   ...continue reading "More Play, Joy, and Activity is Needed in Early School Years"