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Tue, 15 Jun 2004 15:09:49 -0500

HSI - Jenny Thompson

The O Factor

 

The O Factor

 

Health Sciences Institute e-Alert

 

June 15, 2004

 

**************************************************************

 

Dear Reader,

 

In yesterday's e-Alert ( " Talk To Me " ), I told you about

research confirming that high protein intake does not

contribute to poor bone health (as previously believed). In

fact, USDA researchers concluded that high levels of dietary

protein may actually improve bone mass density in older

adults.

 

Of course, not everyone will react the same way to high-

protein intake, so before beginning any major dietary change

it's a good idea to consult with your doctor. And if your MD

or ND has some training in nutrition as well as medicine,

all the better.

 

But if bone health is a concern - and if you're past the age

of 50, it certainly should be - then you might also ask your

doctor to check your homocysteine level with a standard

blood test. Because according to two new studies,

homocysteine is not only a reliable marker for

cardiovascular health, it may also provide an important clue

about the health of your bones.

 

-----------------------------

Fractures on the rise

-----------------------------

 

The two studies both appeared in a recent issue of the New

England Journal of Medicine (NEJM).

 

One study was a collaboration among several prominent

research institutions in Boston, including Harvard and

Tufts. Using blood samples collected from the Framingham

Heart Study, researchers assessed homocysteine levels of

more than 1,100 women and 825 men, all of whom were over the

age of 59. The blood samples were taken in the late 70s and

early 80s, and subjects' medical records were followed from

then until 1998.

 

An analysis of the data showed that women with the highest

levels of homocysteine had almost twice the risk of hip

fracture compared to women with the lowest levels. And among

men the association was even more pronounced: Those with

high homocysteine levels had nearly four times the risk of

hip fracture as the men whose levels were low.

 

The second study - from researchers in the Netherlands -

also compared homocysteine levels with medical records

indicating age-related osteoporotic fractures. Data on more

than 2,400 men and women was analyzed, with follow up

periods that ranged from approximately three years to eight

years.

 

The results were similar to those in the Boston study.

Subjects with the highest homocysteine levels were about

twice as likely to suffer fractures compared to those with

the lowest levels. The researchers concluded that an

elevated homocysteine level " appears to be a strong and

independent risk factor for osteoporotic fractures in older

men and women. "

 

-----------------------------

The folate factor

-----------------------------

 

In an NEJM editorial that accompanied the two studies,

Lawrence G. Raisz, M.D. (a bone biology researcher)

questioned whether homocysteine actually plays a direct role

in weakening bones, or if the association is only

tangential, involving other health problems such as poor

nutrition. In any case, the association is clear, and as HSI

members know, there are already plenty of good reasons to

address elevated homocysteine levels.

 

Fortunately, studies have shown that homocysteine levels may

be controlled with ample amounts of folate - the B vitamin

also known as folic acid. Dietary sources of folate include

citrus fruits, tomatoes, leafy green vegetables, and pinto,

navy and kidney beans. But for many people, folate and B

vitamin supplements may be necessary to sufficiently lower

homocysteine.

 

-----------------------------

Folate helpers

-----------------------------

 

In the e-Alert " The B List " (2/2/04), HSI Panelist Allan

Spreen, M.D., discussed folate supplementation, recommending

a dose of 1.6 grams per day. And because folate can

sometimes mask a vitamin B-12 deficiency, he also recommends

1 mg (1000 mcg) of B-12 per day in sublingual form

(dissolved under the tongue). Dr. Spreen also suggests

adding 100 mg of B-6 and 400-500 mg of magnesium per day to

make folate more effective.

 

But some people don't get a good biological response from

folate. So when a high homocysteine level doesn't respond to

a folate supplement, Dr. Spreen recommends taking 300-500 mg

per day of trimethylglycine (TMG). He describes it as

a " powerful homocysteine-lowering agent. " But because TMG is

expensive, he doesn't use it unless folate appears to be

ineffective.

 

-----------------------------

Checking in

-----------------------------

 

In previous e-Alerts I've encouraged you to ask your doctor

to check your homocysteine levels when you have a blood

test. (Most doctors recommend keeping levels below 12

micromoles per liter.)

 

With these new studies, we have an added incentive to keep

those levels down, for the health of our bones as well as

our hearts.

 

**************************************************************

To start receiving your own copy of the HSI e-Alert, visit:

http://www.hsibaltimore.com/ealert/freecopy.html

Or forward this e-mail to a friend so they can sign-up to

receive their own copy of the HSI e-Alert.

 

**************************************************************

 

.... and another thing

 

Does your medication also make your mouth feel fresh and

minty?

 

I saw the TV ad for the first time last week, but apparently

this product has been out for a couple of months now:

Tylenol " cool caplets. "

 

It's a breath mint! No, it's a pain reliever! No, wait,

you're both right - it's a breath mint AND a pain reliever!

 

I had to bite. On my next trip to the grocery store I bought

small bottle of Tylenol Extra Strength Cool Caplets. At the

first sign of a headache, I downed two caplets and... it

tasted like slightly minty envelope adhesive. The envelope

taste went away pretty quickly, and after that a distinct

mint flavor lingered for about two minutes. And just like

that, I entered the brave new world of flavored headache

relief.

 

Flavored medications are nothing new. Manufacturers have

been producing flavored children's pain relievers for years.

And antacids have been available in flavors for some time

now. But I believe this is a first for an over-the-counter

pain-reliever/fever-reducer in a tablet.

 

Will it catch on? Will we soon see tangy tangerine caplets

or zesty salsa caplets? Or will the breath mint

manufacturers get in on the trend and start offering Tic-

Tacs with a " refreshing blast " of acetaminophen?

 

I hate to spoil this party, but the question has to be

asked: Is it really a sound idea to add the temptation of

flavoring to a pain-reliever that, by the FDA's admission,

plays a role in about 100 unintentional deaths each year?

Most people regard acetaminophen as a completely benign

medication. And that undeserved reputation may only be

reinforced when mint flavoring is added to the mix.

 

Call me old fashioned, but I'll take my mint the old

fashioned way: with a fresh sprig of it on the rim of a

glass of iced tea (or, if the sun has dipped below the

yardarm, a mint julep).

 

To Your Good Health,

 

Jenny Thompson

Health Sciences Institute

 

To start receiving your own copy of the HSI e-Alert, visit:

http://www.hsibaltimore.com/ealert/freecopya.html

Or forward this e-mail to a friend so they can sign-up to

receive their own copy of the HSI e-Alert.

 

**************************************************************

 

Sources:

" Homocysteine as a Predictive Factor for Hip Fracture in

Older Persons " New England Journal of Medicine, Vol. 350,

No. 20, 5/13/04, content.nejm.org

" Homocysteine Levels and the Risk of Osteoporotic Fracture "

New England Journal of Medicine, Vol. 350, No. 20, 5/13/04,

content.nejm.org

" Homocysteine and Osteoporotic Fractures -- Culprit or

Bystander? " Lawrence G. Raisz, M.D., New England Journal of

Medicine, Vol. 350, No. 20, 5/13/04, content.nejm.org

" Vitamins Ward Off Osteoporosis Fractures " Linda A. Johnson,

Associated Press, 5/13/04, apnews.excite.com

" Homocysteine Levels Linked to Fracture Risk " D. Dye, Life

Extension Foundation, 5/14/04, lef.org

 

 

 

 

 

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