How To Preserve Muscle And Bone As We Age: Eat Less Meat And Dairy, More Fruits And Vegetables

Here’s another of Dr. Greger’s videos. This one talks about metabolic acidosis. It dispels the notion that eating an acid-forming diet (lots of meat and dairy) draws calcium from bones and sets one up for osteoporosis. Well, it dispels that direct link (somewhat, you have to eat enough calcium to break even), but it doesn’t get rid of the idea entirely. One way animal protein can be bad for bones: acidosis can lead to muscle wasting; and you need strong muscles to maintain strong bone.

Some studies from his video:

  • This earlier study found that there is a “progressively worsening low-level metabolic acidosis” as we age, and that “such age-related increasing metabolic acidosis may reflect in part the normal decline of renal function with increasing age.”
    Age And Systemic Acid-Base Equilibrium: Analysis Of Published Data, Journal of Gerontology: Biological Sciences, 1996
  • This study began, “metabolic acidosis promotes muscle wasting.” And concluded, “Higher intake of foods rich in potassium, such as fruit and vegetables, may favor the preservation of muscle mass in older men and women.”
    Alkaline Diets Favor Lean Tissue Mass In Older Adults, American Journal of Clinical Nutrition, March 2008
  • This study says that diet-induced metabolic acidosis (eating lots of meat and dairy) increases slowly over time and that the kidneys compensate, in part, by nitrogen wasting. Insulin resistance also plays a role in muscle loss:
    Diet-Induced Metabolic Acidosis, Clinical Nutrition, August 2011
  • This was a review. It presented a body of evidence that reinforces a link between metabolic acidosis and poor health, including loss of muscle mass and bone deterioration. “Muscle wasting however seems to be reduced with an alkaline diet and back pain may benefit from this as well.” The Alkaline Diet: Is There Evidence That An Alkaline pH Diet Benefits Health?, Journal of Environmental and Public Health, 2012

That last paper concluded:

Increased fruits and vegetables in an alkaline diet would improve the potassium/sodium ratio and may benefit bone health, reduce muscle wasting, as well as mitigate other chronic diseases such as hypertension and strokes.

Blue Is Best

According to Greger, and these studies, it’s not good to see your pee becoming more acidic as you age. You can test it if you like with either inexpensive pH strips, or with purple cabbage water. Purple cabbage in the presence of acid turns red; it turns blue in the presence of alkaline (or less acid). I think this would also work with beets and maybe blueberries and purple sweet potatoes, i.e. red is acid, blue is alkaline.

Vitamin B12: What Form Is Best?

This is what the NIH (National Institutes of Health) says:

In dietary supplements, vitamin B12 is usually present as cyanocobalamin [5], a form that the body readily converts to the active forms methylcobalamin and 5-deoxyadenosylcobalamin. Dietary supplements can also contain methylcobalamin and other forms of vitamin B12.

Existing evidence does not suggest any differences among forms with respect to absorption or bioavailability. However the body’s ability to absorb vitamin B12 from dietary supplements is largely limited by the capacity of intrinsic factor. For example, only about 10 mcg of a 500 mcg oral supplement is actually absorbed in healthy people [8].

In addition to oral dietary supplements, vitamin B12 is available in sublingual preparations as tablets or lozenges. These preparations are frequently marketed as having superior bioavailability, although evidence suggests no difference in efficacy between oral and sublingual forms [16,17].

From everything I’ve read, it doesn’t matter what type you take (cyanocobalamin or methylcobalamin) or whether it’s a tablet, lozenge, or liquid spray/drop. What matters is that you take it:

The Institute of Medicine (IOM) recommends that adults older than 50 years obtain most of their vitamin B12 from vitamin supplements or fortified foods [5].

Can you take too much? Not likely. I looked at that a couple years ago:

It would be difficult to take too much vitamin B12 … 3,700 micrograms/day appear to show no risk. And the body has a number of ways to get rid of a large dose.

What’s Going On With Vitamin B6? Colon Cancer?

First, there was this, a chart by the CDC that shows an elevated rate of deficiency for vitamin B6 among Americans:

Then a new study finds “a clear increase in colorectal cancer risk” among those with vitamin B6 deficiency:

Vitamin B-6 And Colorectal Cancer Risk: A Prospective Population-Based Study Using 3 Distinct Plasma Markers Of Vitamin B-6 Status, American Journal of Clinical Nutrition, April 2017

Background: Higher plasma concentrations of the vitamin B-6 marker pyridoxal 5′-phosphate (PLP) have been associated with reduced colorectal cancer (CRC) risk. Inflammatory processes, including vitamin B-6 catabolism, could explain such findings.

Design: This was a prospective case-control study of 613 CRC cases and 1190 matched controls nested within the Northern Sweden Health and Disease Study (n = 114,679). Participants were followed from 1985 to 2009, and the median follow-up from baseline to CRC diagnosis was 8.2 y.

Conclusions: Vitamin B-6 deficiency as measured by plasma PLP is associated with a clear increase in colorectal cancer risk. Furthermore, our analyses of novel markers of functional vitamin B-6 status and vitamin B-6–associated oxidative stress and inflammation suggest a role in tumor progression rather than initiation.

If 1 in 10 people are outright deficient, then a whole lot more are walking around in a state of insufficiency.

As I said in my previous post, not getting enough B6 in the diet isn’t the only cause of deficiency. In fact:

In the 2003–2004 NHANES analysis, plasma PLP [a B6 metabolite] concentrations were low even in some groups that took 2.0–2.9 mg/day, which is higher than the current RDA.

What could be causing deficiency in people who are getting up to twice the RDA? That colon cancer study alluded to it … inflammation, among other causes:

  • Alcohol use (alcohol produces acetaldehyde which decreases PLP formation and competes with PLP in protein binding)
  • Obesity
  • Pregnancy, especially with preeclampsia or eclampsia
  • Malabsorption syndromes such as celiac disease, Crohn’s disease, ulcerative colitis
  • Renal diseases, chronic renal insufficiency, and other kidney diseases
  • Diabetes (it’s associated with inflammation, obesity, and kidney problems)
  • Medications such as antiepileptic drugs, and theophylline used to treat breathing problems
  • Rheumatoid arthritis

I pulled these out of a government fact sheet that goes into more detail about mechanisms. It also points out that taking supplements doesn’t always help, e.g. regarding cancer:

The small number of clinical trials completed to date has not shown that vitamin B6 supplementation can help prevent cancer or reduce its impact on mortality. For example, an analysis of data from two large randomized, double-blind, placebo-controlled trials in Norway found no association between vitamin B6 supplementation and cancer incidence, mortality, or all-cause mortality.

Improving B6 status is more about fixing the conditions that deplete it (see list) than it is about getting enough in the diet (which is easy to do, one cup of chick peas supplies 100% RDA, peanut butter, potatoes, bananas are also good sources.)

Having a hole in the dam keeps the reservoir from being filled.

Really Happy Cows

Wanna see some happy cows? Then you’re in for a real treat! “Koeiendans” is a Dutch terms means “cow dance.” Why are these cows so happy? They’ve been inside their nice warm stalls in the Netherlands for five months, and now they get to go outside to frolic through the fresh new grass in the pasture. You’d be dancing, too!

While we’re on the subject of happy cows, did you know … factory farming or concentrated animal feeding operations (CAFOs)* are relatively new? I probably didn’t eat much factory-farmed livestock growing up because, back then, most livestock was set out to pasture as a matter of course:

Livestock production has become increasingly dominated by CAFOs in the United States and other parts of the world. Most of the poultry consumed by humans was raised in CAFOs starting in the 1950s, and most cattle and pork originated in CAFOs by the 1970s and 80s. CAFOs now dominate livestock and poultry production in U.S. and the scope of their market share is steadily increasing. In 1966, it took one million farms to house 57 million pigs; by the year 2001, it only took 80,000 farms to house the same number of pigs.

* Wikipedia defines a CAFO as “a production process that concentrates large numbers of animals in relatively small and confined places, and that substitutes structures and equipment (for feeding, temperature controls, and manure management) for land and labor.”

Thanks to Miss Cellania and Bill.

Ugali, The “Bread” Of Africa

Have you ever made ugali? It’s a firm, corn-flour-based “bread” similar to polenta. I’ve tried making it in the past but I used grits or cornmeal which didn’t work well. You really need a corn flour. I don’t know why I didn’t think to do this before but I re-ground some cornmeal I had and tried it again. Voila!

Here’s how to make it. For a fanatic cook, this video is mesmerizing:

I was motivated to try it again after reading this Guardian article: Why Is The Staple Food Of Sub-Saharan Africa Ignored By The Rest Of The World?. No, actually, it wasn’t the article, it was their photo. That looks like the ultimate cornbread.

The article links the site, Congo Cookbook, which gives even more instructions, as well as some traditional perspective.

The cornmeal I’m using is made from whole corn; it includes the bran and germ. The grits and other corn products I used before were more processed; the bran and germ had been removed. Maybe this is why it tastes better this time around.

I’m doing this for the taste. But some other benefits:

  • Corn that has been heated and allowed to set is an excellent source of resistant starch.
  • It’s great for gluten-free diets.

I’ve covered studies and written about resistant starch for 10 years. Three things it’s known to lower risk of: colon cancer, diabetes, and blood pressure.


New Study: Africans’ Starch-Rich, Low-Fat Diet Protects From Colon Cancer
Native Africans Had Low Blood Pressure, Probably Due To Low Sodium, High Potassium Diet
Some Carbohydrates Lower Blood Glucose At Subsequent Meals – The Second Meal Effect

Can’t We Reduce Pollution AND Create Jobs?

On his last day as an EPA employee, Mike Cox sent a tough letter to new EPA Administrator Scott Pruitt about administration policies.

You might have heard about this:

EPA Decides Not To Ban A Pesticide, Despite Its Own Evidence Of Risk, NPR, 29 March 2017

The new Administrator of the Environmental Protection Agency, Scott Pruitt, is not a fan of regulation. He also doesn’t believe that carbon dioxide contributes to climate change. His new policies reflect this.

Former EPA employee Mike Cox sent a letter to Pruitt before he left. An excerpt:

“I, along with many EPA staff, are becoming increasing alarmed about the direction of EPA under your leadership … ” Cox said in a letter to Pruitt. “The policies this Administration is advancing are contrary to what the majority of the American people, who pay our salaries, want EPA to accomplish, which are to ensure the air their children breath is safe; the land they live, play, and hunt on to be free of toxic chemicals; and the water they drink, the lakes they swim in, and the rivers they fish in to be clean.”

I side with Cox. But, according to the leader of Trump’s EPA transition team, Myron Ebell, who responded to Cox, I’m not sympathizing with the people whose jobs have been destroyed because of pollution regulation:

Now that Trump is moving toward “radically downsizing the EPA,” Ebell said, “employees who are opposed to the Trump Administration’s agenda are either going to conduct themselves as professional civil servants or find other employment or retire or be terminated. I would be more sympathetic if they had ever expressed any concern for the people whose jobs have been destroyed by EPA’s regulatory rampage.”

From: EPA Staffer Leaves With A Bang, Blasting Agency Policies Under Trump, Washington Post, 7 April 2017

Can’t we reduce pollution and tackle climate change while also creating jobs?

Nutrient Deficiencies In US, Measured By CDC

Second National Report On Biochemical Indicators Of Diet And Nutrition In The U.S. Population, 2012 Report, Centers For Disease Control and Prevention

That’s the Executive Summary. Here’s the full report.

And here’s a quick summary:

Figure 1. Prevalence estimates of nutrient deficiencies in U.S. persons, National Health and Nutrition Examination Survey, 2003–2006.

Not many of us are experiencing nutritional deficiencies. This graph is an estimate. Some details:

  • Children and adolescents were rarely deficient in vitamin B12 (< 1%), while older adults were more likely to be deficient (4%).
  • The likelihood of being vitamin B6 or B12 deficient was higher in persons 40 years and older.
  • Men were more likely to be vitamin C deficient (7%) compared to women (5%).
  • Non-Hispanic black (31%) and Mexican-American (12%) people were more likely to be vitamin D deficient compared to non-Hispanic white people (3%).

It isn’t just diet that can lead to a deficiency:

  • Pigmentation reduces vitamin D production in the skin; darker skin makes less vitamin D than lighter skin.
  • Vitamin C can be used up by smoking or exposure to air pollution.
  • Vitamin B12 is more difficult to absorb as we age.
  • Alcohol uses up B vitamins, especially B1 (thiamine).

Then again, sometimes it is diet, so I rummaged around NutritionData:

  • One orange supplies more than the RDA (60 mg) for vitamin C.
  • Good vegetarian sources of vitamin B6 are whole grains (bran and germ the highest), legumes (2 tablespoons peanut butter or 1/2 cup chick peas have about half the RDA of 1.3 mg), and lots of vegetables (like peppers, cabbage, spinach, etc.).
  • An ounce of almonds has about half the RDA (15 mg) for vitamin E.

What Do You Think Of Meal-Replacement Beverages For Weight Loss?

The Look AHEAD study was one of the largest weight loss studies (a randomized control trial) ever undertaken:

The Look AHEAD Study: A Description of the Lifestyle Intervention and the Evidence Supporting It, Obesity, May 2006

They used liquid meal replacement in the intervention group, 2 meals/day replaced for 6 months, 1 meal thereafter, with replacement snack bars once a day. The study ran for about 12 years.

Participants potentially can choose from four meal replacements, including SlimFast (SlimFast Foods), Glucerna (Ross Laboratories), OPTIFAST (Novartis Nutrition) and HMR (HMR, Inc.). All products are provided free of charge.

What do you think? Are meal-replacement beverages a healthy way to achieve weight loss?

Here’s an example of one, SlimFast. Eight, 10-ounce bottles cost about $26:

Nutrition Facts, Per Serving; 190 calories, 6g fat, 210mg sodium, 5g fiber, 18g sugar, 10g protein

INGREDIENTS: Fat Free Milk, Water, Sugar, Cocoa (Processed with Alkali), Canola Oil, Fructose, Gum Arabic, Milk Protein Concentrate, Cellulose Gel, Mono and Diglycerides, Hydrogenated Soybean Oil, Potassium Phosphate, Maltodextrine, Soy Lecithin, Cellulose Gum, Natural and Artificial Flavor, Carrageenan, Sodium Bicarbonate, Sucralose and Acesulfame Potassium (Nonnutritive Sweeteners), Sodium Citrate, Citric Acid.

Vitamins and Minerals: Magnesium Phosphate, Calcium Phosphate, Sodium Ascorbate, Vitamin E Acetate, Zinc Gluconate, Ferric Orthophosphate, Niacinamide, Calcium Pantothenate, Manganese Sulfate, Vitamin A Palmitate, Pyridoxine Hydrochloride, Riboflavin, Thiamin Mononitrate, Folic Acid, Chromium Chloride, Biotin, Sodium Molybdate, Potassium Iodide, Phylloquinone (Vitamin K1), Sodium Selenite, Cyanocobalamin (Vitamin B12) and Cholecalciferol (Vitamin D3).