Category Archives: Nutrients - Page 13

Gwyneth Paltrow, Osteopenia, and Diet Advice from the Daily Mail

Posted by on June 27, 2010 19 comments

At her health site Goop.com, Gwyneth Paltrow recently revealed that a broken leg she suffered several years ago was due to osteopenia, or brittle bone disease, possibly caused by sun avoidance and low vitamin D:

I suffered a pretty severe Tibial plateau fracture a few years ago (requiring surgery) which led the orthopaedic surgeon to give me a bone scan, at which point it was discovered I had the beginning stages of osteopenia. This led my western/eastern doctors in New York to test my Vitamin D levels, which turned out to be the lowest they had ever seen (not a good thing). I went on a prescription strength level of Vitamin D and was told to … spend a bit of time in the sun! I was curious if this was safe, having been told for years to stay away from its dangerous rays, not to mention a tad bit confused. [1]

Low vitamin D can certainly cause osteopenia and fractures. Bone density is highest and fracture rates lowest when serum 25(OH)D levels are between 32 and 45 ng/ml. [2] (As an aside, 25(OH)D levels should be tested routinely. It’s remarkable that Paltrow’s doctors waited until she had fractured a bone to measure her vitamin D levels.)

In Paltrow’s case, however, it’s quite likely that other nutritional and dietary deficiencies were also at work.

For 11 years Ms. Paltrow has avoided meat and dairy and eaten a macrobiotic diet in which most calories come from grains and legumes – two of the toxic foods that the PerfectHealthDiet counsels avoiding.

Grain consumption has long been known to damage vitamin D status and bone health. Indeed, it is difficult to induce bone frailty in laboratory animals without feeding them grain. In Edward Mellanby’s original experiments leading to the discovery of vitamin D, he induced rickets by feeding dogs a diet of oats or wheat bread. [3] In human infants, wheat bran induces rickets. [4] In addition to interfering with vitamin D, grains also contain high levels of phytic acid, which interferes with bone mineralization by blocking absorption of calcium and magnesium.

Another crucial factor in bone health is vitamin K2. Since dairy fats are the leading source of vitamin K2, it’s likely Ms. Paltrow was deficient in this crucial vitamin. Most people are deficient in vitamin K2 – let alone those who avoid meats and dairy.  In clinical trials, vitamin K2 supplementation reduced non-vertebral fractures by a remarkable 81%. [5]

Given Paltrow’s avoidance of animal fats, it’s likely that omega-6-rich vegetable oils were an outsized share of her diet, and fatty seafood a small share. But a high omega-6 to omega-3 ratio reduces bone density. [6]

The long and the short of it is that Ms. Paltrow would benefit from more meat, more fat, more fat-soluble vitamins, and fewer grains and legumes.  A commenter in Britain’s Daily Mail quipped:

Maybe if she started having a nice juicy steak for dinner each day instead of the poached peelings from half an apple … [7]

Hyperbolic, no doubt, but good advice!

[1] Gwyneth Paltrow, June 17, 2010, http://www.goop.com/?page=newsletter_vn&id=177. Hat tip Frank Hagan, http://www.lowcarbage.com/2010/06/27/gwyneth-paltrow-and-osteopenia/.

[2] Bischoff-Ferrari HA et al. Positive association between 25-hydroxy vitamin D levels and bone mineral density: a population-based study of younger and older adults. Am J Med. 2004 May 1;116(9):634-9. http://pmid.us/15093761.

[3] Mellanby E. (March 15 1919) An experimental investigation on rickets. The Lancet 193(4985):407-412.

[4] Zoppi G et al. Potential complications in the use of wheat bran for constipation in infancy. J Pediatr Gastroenterol Nutr. 1982; 1(1): 91-5. http://pmid.us/6310074.

[5] Cockayne S et al. Vitamin K and the prevention of fractures: systematic review and meta-analysis of randomized controlled trials. Arch Intern Med. 2006 Jun 26;166(12):1256-61. http://pmid.us/16801507.

[6] Watkins BA et al. Dietary ratio of n-6/n-3 PUFAs and docosahexaenoic acid: actions on bone mineral and serum biomarkers in ovariectomized rats. J Nutr Biochem. 2006 Apr;17(4):282-9. http://pmid.us/16102959. Watkins BA et al. Dietary ratio of (n-6)/(n-3) polyunsaturated fatty acids alters the fatty acid composition of bone compartments and biomarkers of bone formation in rats. J Nutr. 2000 Sep;130(9):2274-84. http://pmid.us/10958824.

[7] “Gwyneth Paltrow:  I’m suffering from brittle bone disease,” Daily Mail, June 26, 2010, http://www.dailymail.co.uk/tvshowbiz/article-1289644/Gwyneth-Paltrow-Im-suffering-brittle-bone-disease.html.

Fish, Not Fish Oil Capsules

Posted by on June 16, 2010 50 comments

Yesterday I recommended eating about a pound a week of salmon or sardines as part of the strategy for achieving an optimal omega-6 to omega-3 ratio.

Yet this is not the way many health-conscious people obtain omega-3 fatty acids.  They buy fish oil capsules. 

The trouble with this approach is that omega-3 fats are chemically fragile:  their carbon double bonds are easily oxidized.  EPA has 5 double bonds and DHA 6 double bonds, so they are the most vulnerable of all dietary fats.  They easily become rancid.

Fish oil capsules often sit on a shelf for months before they are eaten.  If someone offered you the opportunity to eat salmon that had been sitting on a shelf for six months, would you do it?  No? Then why accept the same deal with salmon oil?

In fact, clinical trials have compared eating fish to eating fish oil capsules.  Fish consumption has an excellent record in a number of clinical trials, but fish oil capsule supplements do not. 

In the Diet and Angina Randomized Trial (DART-2), 3114 men with stable angina were followed for 3-9 years. There was a control group, a group advised to eat oily fish like salmon, and a group taking 3 fish oil capsules daily.  There was a significant increase in sudden cardiac death among the subgroup taking fish oil capsules. [1]

So, give up the fish oil capsules:  they’re all too likely to poison you.  Instead, buy some fresh fish.  Poached or baked salmon is an excellent summer dinner.

[1] Burr ML et al. Lack of benefit of dietary advice to men with angina: results of a controlled trial. Eur J Clin Nutr. 2003 Feb;57(2):193-200. http://pmid.us/12571649.

Omega-3 Fats and Cardiovascular Disease

Posted by on June 15, 2010 30 comments

The importance of achieving a good omega-3 to omega-6 ratio has been demonstrated repeatedly in clinical trials and epidemiological studies.  Cardiovascular disease mortality is especially strongly dependent on this ratio [1]:

This plot shows coronary heart disease mortality plotted against the fraction of long polyunsaturated fats in tissue that are omega-6, not omega-3.  It’s best to have around 30% omega-6, 70% omega-3.  But most Americans have around 78% omega-6, 22% omega-3.  Their omega-6 to omega-3 ratio is 9 times the optimum, and CHD mortality is ten-fold higher than is necessary.

Dr. Bill Lands, one of the pioneers in omega-3 and omega-6 science, notes that the tissue ratio is determined by how much of each type of fat is eaten:

There seems to be no ‘corrective’ metabolic response to prevent fatal tissue combinations from being developed. As much as humans might wish for some protective re-adjustment of the metabolic promiscuity, the enzymes seem to continue assembling harmful and harmless combinations in response to supplies ingested – without much regard to or feedback from the consequences. [2]

So it’s important to eat these fats in the right ratio.

How do you do that?  These steps:

  1. Minimize omega-6 fats by:
    • Avoiding most vegetable oils, including soybean oil, corn oil, safflower oil, and canola oil.
    • Using low-omega-6 oils, such as coconut oil, butter, beef tallow, olive oil, and lard, in cooking and dressings and sauces.
    • Regularly eating low-omega-6 red meats, like beef and lamb.
  2. Get sufficient omega-3 fats by eating 1 lb per week of fatty cold-water fish, like salmon or sardines.

These simple dietary changes can reduce your risk of dying from a heart attack by a factor of ten.

Yet how many doctors recommend these steps?  Indeed, many recommend the opposite:  avoiding saturated fats in coconut oil, butter, and beef tallow; avoiding red meats; and eating lots of vegetable oil.

This is a great example of our First Law of Health:  Every conventional dietary recommendation is wrong.

[1] Lands WE. Dietary fat and health: the evidence and the politics of prevention: careful use of dietary fats can improve life and prevent disease. Ann N Y Acad Sci. 2005 Dec;1055:179-92. http://pmid.us/16387724. Lands WE, http://efaeducation.nih.gov/sig/personal.html.  Hat tip Stephan Guyenet, http://wholehealthsource.blogspot.com/2008/09/omega-fats-and-cardiovascular-disease.html.

[2] Lands WE, http://efaeducation.nih.gov/sig/composition%20maintained.pdf.