Paula Mee, Paula Mee Nutrition & Dietitian Consulting, Nutrition Dietician, Nutrition Dietitian, Nutrition Advice, Healthy Eating, Healthy Living, Diet Advice, Professional Nutritional Advice
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Fad Diets and Bone Health
      
The main reason for the high incidence of Osteoporosis in Ireland is because of our lifestyle. We don’t eat properly, we don’t exercise enough and we don’t look after our weight. Result? Our bones gradually become more and more brittle until one day one of them fractures or breaks.

In women, this process is greatly influenced by the female hormone oestrogen. In general, the higher the oestrogen level the stronger our bones. So when we reach the menopause and our oestrogen level falls, our bones rapidly lose strength.
      
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This is why Osteoporosis primarily affects post-menopausal women. So is there a way of protecting ourselves against Osteoporosis, especially if we are approaching the menopause? Well yes, eat well, take more exercise and look after your weight….
      
Eat a well balanced diet – it’s not just Calcium that’s important!
      
Calcium is the mineral that springs to mind immediately when we think of our bone strength. It is important - but now most experts believe that the situation is more complicated. In addition to calcium, we need the right amount of other nutrients, too. Why?
      
Because even if we eat lots of calcium we can’t absorb it properly unless our diet includes enough magnesium, Vitamin A and Vitamin D.
Even if we absorb enough, we can’t retain it unless we eat enough Vitamin B6 and Vitamin K.
Lastly, without enough Vitamin C, we can’t produce enough collagen, which is also important.
      
The best way to get all the nutrients you need is to include the following foods daily:
      
6 or more servings of carbohydrate rich foods, depending on how active you are. Eat wholegrain carbs where possible and choose pasta, basmati rice, muesli or oat-type breakfast cereals more often than potatoes and bread.
5 or more servings of fruit and vegetables
3 servings of low fat milk, cheese and yogurt. Calcium is sometimes bound by phytates (found in wholegrain cereals and pulses) and oxalates (found in spinach and rhubarb) which make it unavailable for absorption by the body.
Milk and dairy products contain readily available calcium and it seems that calcium not only influences blood pressure but it’s also very important for weight loss.
      
Clinical trials have proven the dairy products/weight-loss connection. A study by Zemel recently published in Obesity Research, the official journal of the North American Association for the Study of Obesity, followed obese adults for 24 weeks. Three groups were placed on reduced-calorie diets. Those who ate 3-4 servings of dairy foods each day lost significantly more weight than the group consuming few / no dairy foods, and also the group who took calcium supplements.Ref 2004, 12;582 –590.

Eating dairy foods daily seems to be particularly effective at burning fat in the abdominal area. “By reducing body fat in the abdominal region, people may also reduce their risk of developing several chronic diseases, including heart disease, type 2 diabetes and hypertension”, said Zemel. Professor Zemel believes, “It is clear from the research that the unique combination of essential nutrients in dairy foods has a powerful, positive impact on metabolism and weight loss”. However, dairy foods are not magic. If calorie intake is excessive, weight gain will occur. The good news is that a moderate reduction in calorie intake, combined with 3 servings of dairy foods daily, as recommended by the Department of Health, can make a huge difference in the body’s ability to lose weight.

These important findings come at a time when the majority of Irish adults are either overweight or obese, meaning many are at risk of weight-related health problems. A recent US research review of almost 100 studies spanning 2 decades found that the incidence of obesity could be reduced by 25% over 5 years if everyone consumed an adequate intake of dairy products. Unfortunately, Irish men consume just 2 and a half servings daily whilst Irish women consume a mere 1 and a half servings.
      
2 servings of beans, peas, lentils, nuts, fish, meat or chicken. Few foods contain large quantities of vitamin D, necessary for the absorption of calcium. Fish liver oils have very high levels and oily fish, eg sardines and tuna, are also rich sources.
Lastly, try not to consume too many caffeine containing drinks/foods such as coffee, colas and chocolate, nicotine or too much alcohol (over 14 units/week for women and 21 units/week for men). These tend to weaken our bones.
      
If you’re overweight avoid fad diets which promise quick results and involve little or no exercise. They are ubiquitous and always "new" and "better" than the previous diet. The most recent craze is low-carb high-protein diets, where carbohydrate is reduced and protein intake increased substantially. The problem is carbohydrate is an important fuel for our brains and working muscles.

High-protein diets induce a quick drop in weight primarily through loss of body fluids caused by the diuretic effect of eliminating most carbohydrates. Glycogen, or ‘stored carbohydrate’, is lost from the muscles as well and this can cause fatigue. Some of these diets also induce ketosis, a metabolic condition associated with low blood levels of insulin and resulting when the body is deprived of dietary carbohydrates. Sustained ketosis also causes a loss of appetite, which may lead to lower total calorie intake. The side effects that often accompany ketosis are dehydration, diarrhoea, weakness, headaches, dizziness and bad breath. There are no long-term studies to prove the efficacy and safety of these low-carb high-protein diets.
Low-carb diet recommendations to decrease our intakes of white sugar, sweets, sugary soft drinks and white bread are healthy enough changes in themselves. But reducing other carbohydrates, such as fruits and vegetables, wholegrain breakfast cereals and oatmeal, whole meal breads, pasta and rice which are vital sources of fibre, vitamins and minerals, and energy - can be terribly unhealthy in the long run.

Three out of four Irish people are not eating enough fibre. These diets can be terribly low in fibre and can increase the risk of constipation and more serious bowel disorders.

Heart disease is the biggest killer in the country and many of these diets delude people into believing they can eat as much cream and saturated fat as possible.

Finally one third of all cancers are diet related and we know that diets that are high in fat, low in fibre and low in antioxidant vitamins can increase your risk of cancer. Yes, you will lose weight on these diets mainly because protein foods are more satiating and they keep hunger at bay. However many are unsustainable in the long-term and nothing about them encourages the dieter to learn about weight management strategies that can really help such as portion control and serving sizes. So the weight tends to pile on again after the diet is abandoned.

Many fad diets should certainly be avoided by people with certain disabilities and health related conditions. For example, a wheelchair user who is at risk for osteoporosis from little or no weight-bearing activity is at greater risk by consuming a diet with restricted calcium intake because many fad diets exclude dairy foods altogether. Low-carb, high-protein diets force the kidneys to handle excess waste products. A build-up of ketones in the blood can be risky for people with diabetes because it can speed the progression of diabetic renal disease. These diets may also be contraindicated for people with spina bifida or hypertension, because of stress on the kidneys and vascular system. In individuals with kidney or liver disease, the excess protein may increase the risk of worsening their disease.
      
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Keep in mind that research on these matters is on-going and is subject to change. The information presented is not intended as a substitute for medical treatment. It is intended to provide ongoing support of your healthy lifestyle practices.
        
        
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