Monday, January 22, 2007

India has world's worst rate of osteoporosis

By Russell Eaton
Author of The Milk Imperative

An extensive study published in Jan. 2006 revealed that Indians are increasingly being afflicted with osteoporosis. This study, conducted by the National Institute for Research in Reproductive Health, shows that an estimated 61 million Indians suffer from osteoporosis.

Commenting on the study, the director-general of the World Health Organization (Gro Harlem Brundtland) said that osteoporosis will see a manifold increase in the developing world.

In India both genders are affected by osteoporosis, as shown by another study by the Britannia New Zealand Foods and the Arthritis Foundation of India. This has revealed that in cities like Kolkata and Chennai, 45 per cent of men have brittle bones!

The World Health organization reveals that one out of three adult females in India suffers from osteoporosis, making India one of the worst affected countries in the world. The Arthritis Foundation of India says there has been an estimated 200 per cent jump in cases across Asia in 10 years.

Why is osteoporosis increasing at such an alarming rate in India? The answer unfortunately is simple: a dramatic increase in milk consumption in India in recent years has gone hand-in-hand with a dramatic rise in osteoporosis. In 2002, some 18,000 million liters of milk where produced by Operation Flood's cooperative unions each day. As a result, milk consumption in India has risen from a low of 107 grams per day in 1970 to over 220 grams per day in 2002 – people in all parts of India are now able to buy and consume dairy milk without scarcity of supply. Since 2002, the increase in milk production and consumption in India has risen enormously, growing at a rate of over 4% per year according to FAO. This makes India the fastest growth market in the world in milk production and consumption.

Further proof of the link between milk consumption in India and osteoporosis comes from an alarming study conducted by TS Syamala and M Sivakami. The report, published by the Institute for Social and Economic Change in Bangalore in Jan. 07, shows that Indian women are now attaining menopause at an early age of 30. Premature menopause puts women at higher risk of being affected with osteoporosis, heart diseases, diabetes, hypertension and breast cancer.

According to the Study, early menopause results in decreased oestrogen levels and this in turn promotes an increased incidence of osteoporosis. The report, which was presented in the Indian Parliament, said that in India 3.1 per cent of women are already in menopause by the age of 30-34, and which rises to eight per cent for the age bracket of 35-39 with the incidence of menopause being quite rapid after the age of 40-41. The study goes on to say that ‘nutrition and premature menopause are strongly interlinked’.

In the book The Milk Imperative the link between dairy milk consumption and premature menopause is examined, together with the supporting evidence. The sequence of events goes something like this: milk consumption ► harmful calcification ► premature menopause ► lack of oestrogen ► onset of osteoporosis.

"An increase in calcium utilization is associated with the earliest physical signs of puberty. We conclude that longitudinal data demonstrates a change in bone mineral metabolism during early puberty associated with maturation of the hypothalamic-pituitary axis and physical changes of breast development. These changes lead to increases in multiple aspects of calcium metabolism during early puberty. " (Stevan A, et al, Calcium Absorption, Bone Mass Accumulation, and Kinetics Increase during Early Pubertal Development in Girls, The Journal of Clinical Endocrinology & Metabolism Vol. 85, No. 5 1805-1809).

Monday, January 08, 2007

Calcium and Vitamin D do not mix

The FDA (US Food and Drug Administration) on Friday Jan. 5th announced its proposal to allow new health claims on foods and dietary supplements containing calcium and vitamin D to indicate that these nutrients have the potential to help reduce risk of osteoporosis.

The proposed rule allows food and beverage manufacturers to include new information on the label and in the meantime eliminate some other information which is no longer justified.
The claim on calcium for its preventative role in osteoporosis was authorized in 1993, according to the FDA. The new rule amends the existing health claim by allowing claims on both calcium and vitamin D for their potential preventative effect against osteoporosis.

This is a disastrous development. Getting enough vitamin D and calcium is vital to good health, but taking supplements that combine vitamin D and calcium has been shown to weaken bones and increase the risk of osteoporosis.

The FDA proposal is a response to a health claim petition submitted by the Beverage Institute for Health and Wellness, the Coca-Cola Company. The FDA bases its decision on its review of the publicly available scientific evidence including the 2004 Surgeon General's report on Bone Health and Osteoporosis and the 2000 NIH Consensus Statement on Osteoporosis, Prevention, Diagnosis and Therapy.

While calcium and vitamin D play an important role in maintaining bone health in adults, a few issues need to be addressed, said a scientist affiliated with For instance, supplementation of calcium and vitamin D may not be as important in children as in adults. Healthy children who eat a healthy diet and follow a healthy lifestyle rarely need supplements of vitamin D and calcium although supplementation and fortification of calcium and vitamin D may help certain children, according to a review article.

Calcium and vitamin D supplements do not benefit all adults whether taken separately or formulated together. A study published in 2005 in the Lancet finds that supplementation of vitamin D, calcium, or both, does not lower the risk of secondary bone fracture from osteoporosis in the elderly who have had one incident of bone fracture.

Elderly people who are frail and at risk for bone fractures may be helped somewhat by giving them both vitamin D and calcium. But the benefits may be marginal and appear only to help those who live in nursing homes or other institutions, according to Alison Avenell, M.D., of the University of Aberdeen, Scotland, and her colleagues who published their review of 38 randomized or quasi-randomized trials in the July 2005 issue of issue of The Cochrane Library.

Potential problems exist for uncontrolled intake of calcium and vitamin D. Too much calcium in the blood (hypercalcemia) has been associated with use of calcium supplementation. Mild hypercalcemia may not result in any symptom, or cause loss of appetite, nausea, vomiting, constipation and dry mouth, thirst and frequent urination. A severe condition could cause confusion, delirium, coma, and if not treated, death, according to the Linus Pauling Institute.

High levels of vitamin D in the blood (hypervitaminosis D) are also toxic as it induces abnormally high serum calcium levels (hypercalcemia). Virtually all research is showing that vitamin D supplementation in moderation is good for health provided it is not combined with calcium supplementation.

When vitamin D and calcium supplementation are taken together, this increases bone turnover, the rate at which calcium is pumped in and out of bone tissue. This in turn depletes the body’s finite reservoir of bone-making cells.

Every time calcium is processed into new bone a few bone-making cells die. When this happens on a regular basis, the erosion of bone-making cells reduces the body’s capacity to make new bone to replace old bone that is always melting away. The result is osteoporosis.

To protect bones it is best to get enough calcium from a healthy varied diet, and take vitamin D in moderation on its own, i.e. not combinecd with calcium. For the same reason, it is best to avoid dairy milk on days when vitamin D supplements are taken. Dairy milk, which is highly acidic, is also high in calcium and when combined with vitamin D supplementation it has the effect of eroding bone-making cells and increasing the risk of osteoporosis.

For the supporting evidence and latest research on this subject see the book The Milk Imperative.