mom health

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Osteoarthritis causes pain or dysfunction in 20% of the elderly, and is often present inthose aged 40 (US figures). Although NSAIDs are widely used, these are associated withadverse effects. Non-pharmacological interventions for pain relief and function includesuperficial and deep heat, cold, exercise, weight loss, acupuncture, transcutaneouselectrical nerve stimulation (TENS), low energy laser, vibration, topically applied

creams, pulsed electromagnetic fields and orthotic devices.

Diathermy (deep heat) followed by exercise

One evaluator-blind trial compared short-wave diathermy and exercise with exercisealone in 42 patients over 4 weeks. There was no benefit of diathermy over control on anymeasure.

One double-blind trial compared ultrasound with sham ultrasound in 74 patients over 4-6weeks. There was no benefit of ultrasound over placebo on any measure.

Exercise

One pseudo-randomised trial compared quadriceps strengthening exercises plusdiathermy with diathermy alone in 61 patients over variable follow-up periods. There wasa statistically significant 10% therapeutic gain in the exercise group on a measure of functional incapacity (including pain), and a significant improvement in muscle strength.

One trial of 120 patients with hip, knee or ankle osteo- or rheumatoid arthritis comparedtwo different types of aerobic exercise plus a stretching and strengthening exercise

programme with a stretching and strengthening exercise programme alone. Aerobicexercise was either pool activity or walking, and the programme was 3 times weekly for

12 weeks. There were no group differences in pain relief. There were significant benefitsof aerobic exercise (both types) on aerobic capacity and all subscales of the ArthritisImpact Measurement Scale (AIMS) (i.e. physical activity, anxiety and depression).

One non-blind trial of 102 patients compared an eight week programme of lectures, groupdiscussions, supervised light stretching and strengthening followed by up to 30 minutesof walking with routine care and telephone follow-ups. There was a significantimprovement with exercise compared with control in measures of pain, walking test,AIMS subscales for physical activity, and for arthritis impact.

An estimated 29 million Americans have osteoarthritis (OA), a painful condition thatoccurs when the cartilage cushioning joints breaks down, allowing the bones to rubtogether. The most common form of arthritis, OA typically affects people over age 45.

While medication can help relieve the pain, swelling and loss of movement associated withosteoarthritis, guarding your joints from the wear and tear that contributes to the medicalcondition is the best strategy.


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Preventing osteoarthritis is a lifelong commitment, says Dr. Joel Silverfield, whospecializes in the treatment of arthritis in Tampa, Fla. "That begins with understandingyour risk of developing OA.

"Some people just have better cartilage than others," Dr. Silverfield adds. If you inherit atendency for cartilage that is defective or brittle or thin, it can wear out sooner. "Thatswhy some people are 80 and dont have OA and others get it in their 30s," he explains.

The joint at the base of the thumb is the most common site for osteoarthritis. Thatsbecause over a lifetime, the thumb is a hard-working joint. While it also commonly occursin the hips, knees, feet and hands, OA can develop in any joint in the body.

Heres to joint health

"Keeping your weight in a normal range reduces stress on your knees and hips," says Dr.Silverfield, who suffers from a type of spinal arthritis that motivates him to manage hisweight. "Extra weight means extra wear and tear, and that leads to pain."

Gerry Chrisman, 62, was in her 40s when she saw her doctor about knee pain. "He startedtalking about surgery, but I told him I didnt do surgery, so his alternative was to lose 20pounds," she says. By watching her diet and exercising, Chrisman eventually lost 45pounds. "Now I dont have any pain in my knees," says the Grain Valley, Mo. (pop. 5,160),resident.

Staying physically active is the No. 1 thing to keep arthritis pain at bay, so Chrismanteaches water aerobics classes for others with arthritis. "I saw my father-in-law become aninvalid as a result of arthritis," she says. "I decided that that wasnt going to happen tome."

Give your joints a break

Preparing your muscles for any activity with warm-up exercises is another preventionstrategy, Dr. Silverfield says. These can include stretching your arms and legs and gentlyrotating joints to increase circulation.

Using safety and support equipment also can help. Even the most skilled rollerblader cantake a spill that can damage joints. Tennis players and runners who wear well-constructedshoes are investing in the life-long function of their knees and hips. Always wearing aseatbelt in the car can protect joints from injury should an accident occur.

While being active is good for joints, its also true that too much of the same activity canwear them out, contributing to osteoarthritis, Dr. Silverfield says. Repetitive tasks,

whether its operating the mouse on your computer, knitting or standing for long periods,wear on joints. So mix it up, if you can. Learn to mouse with either hand. Take breaksevery 15 to 20 minutes. Press the palms of your hands together at chest level, then flipyour hands over so the knuckles are facing and press again. Then shake your hands briskly.

If your job requires standing in one spot, add a rubberized mat and a small stool to propone foot on. Then shift your position every few minutes and switch feet on the stool. Easeyour back by stretching from side to side and extending your arms overhead.


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"OA doesnt have to control your life," Dr. Silverfield says. "Protect your joints from injury,stay active and keep an eye on the scale. When you do, you reduce your risk of developingOA."

For more information on osteoarthritis, call the Arthritis Foundation at (800) 568-4045 orlog on to www.arthritis.org.

Worst Seven Foods for Health and Longevity

Butter Cheese Potato Chips and French Fries Doughnuts Salt Sausage, hot dogs Pickled, smoked or barbequed meat

We live in an age of disease. It seems like everyone is popping a pill nowadays. And kidsare taking the brunt of it. From ADHD and to ADDsurely, something is wrong withyour child! But all these new-fangled conditions are overshadowing traditional maladieslike asthma. Just like a Hollywood agent, Sorry baby, you aint hip anymore.

Maybe thats why new federal guidelines are coming out this summer urging doctors to pay closer attention to children with asthma . Lauran Neergaard of the Associated Presshas more:

Federal guidelines due this summer are expected to urge doctors to more closely monitor whether treatment is truly controlling everyday symptoms and improving patients' quality

of life and to adjust therapy until it does.

Already, a campaign is under way to teach patients to recognize they need better help,and to tell them how to convey that to a doctor. If the doctor's happy that you've had noflare-ups but doesn't know you had to quit playing soccer to do it, you're not achievinggood control.

Too often, physicians don't realize how severe symptoms are, says Dr. Jill Halterman, a pediatric asthma specialist at the University of Rochester. With children, their own parents may underestimate symptoms.

It's more complicated than denial: When wheezing while running or waking up at nightcoughing has been routine for years, people may not know to complain.

"It may be part of what they view as normal," says Halterman, who is studying thecontrol gap. "We're hoping we can change that so the goal can really be for the child tohave no symptoms and no limitations on activities."
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Now, Im sure every kid with chronic asthma wants to live without symptoms and haveno limitations, but what if they could go one step further? What if they could knock their asthma out of the box? Impossible? Not so according to Dr. Fuhrman. In Disease-Proof Your Child he explains that nutritional excellence is a sure-fire way to shake asthma at itsfoundation:

Eating protein-rich and fat-rich foods of animal originmeat, cheese, fried food, andsaturated fatis associated with a higher prevalence of both allergies and asthma.1Eating in fast food restaurants and eating a lower intake of vegetables and other fiber-richfoods has been implicated by numerous studies. The same studies also show that thechildren in the lowest third of vitamin E intake were found to have three times theincidence of asthma compared to those children in the highest third of vitamin E intake.2Vitamin E is a fat-soluble vitamin found in greens, raw nuts, and seeds; it is not found inanimal products. The consumption of white bread, butter, and margarine has also beennoted to be strongly associated with asthmatic symptoms.3

The same pattern emerges. What is needed to battle the development of asthma allergiesis the same adequate intake of omega-3 fat as well as diet rich in fruits and vegetables.Eating high antioxidant- and phytochemical-containing foods is related to lower occurrence of childhood allergies and asthma.4 Nutritional excellence can normalize anexcessive inflammatory response. The inflammatory cascade release chemicals thatattract white blood cells and fluid into the area, which results in the tightness andswelling that create the symptoms of asthma. When nutrient intake is low, the lungtissues become overly sensitive to irritating stimuli.

In a previous post Dr. Fuhrman talks about a young asthma sufferer who achieved great

results with nutritional excellence. From Asthma Can Often Be Controlled With Proper Nutrition :

Jonathan was an excellent student and was keenly interested in learning how what he ateaffected his health and his breathing problem. At the initial visit to my office, Jonathanwas instructed on using a spacer with an inhaler and was taken off his three times a daynebulizer treatments. I told him his recovery hinged on the amount of green vegetables hewas capable of eating. He was more than cooperative. This eight-year-old said to me, "Iwill eat dirt if you can fix my breathing." So I said, "How about if I give you great-tastingreal food to fix your asthma. You can be a lot better within a year." Jonathan is now infourth grade. It took about eight months until he no longer required any medication. He isnow the picture of health and uses no inhalers or other asthma medications.

Also, according to Dr. Fuhrman breastfeeding is an important part of stopping thedevelopment of asthma in children. Heres a couple of posts talking about that:

Childhood Asthma and Allergies NY Times: Breastfeed for Better Health
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Continue Reading Wednesday, April 11, 2007 Posted By Gerald Pugliese In Full Text Feed , Healthy Food ,Hurtful Food , Research

Eating Together is Better

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Growing up we never watched television and ate dinner at the same time. Now that I livealone I still dont. And its a good thing. Because according to a new study, you eat better when youre not watching the tube . Amanda Gardner of HealthDay News reports:

For this study, more than 1,300 parents or guardians of children participating in NewYork's Special Supplemental Nutrition Program for Women, Infants and Children weresurveyed on how many days a week the family ate dinner together, the number of dayseach week the TV was turned on during dinner, and how often fruits and vegetables were

served.

More fruits and vegetables were served on the nights families ate dinner as a unit.Servings of fruits and vegetables decreased each night the TV was turned on during themeal. Neither eating together nor having the television on seemed to have anyrelationship with servings of milk.

Fruits and vegetables are important components of any healthful diet and have beenassociated with decreased cardiovascular disease and certain types of cancer.

Are Dairy Products the Answer to Osteoporosis?

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Written by Dr. Fuhrmans colleague Anna Quisel, M.D. for the July 2003 edition of Healthy Times :

As a woman and a breast-feeding mother, I almost feel guilty when someone asks, Youdont drink milk? How do you get your calcium? As people learn more about the

problems associated with osteoporosis, interest in calcium is skyrocketing. Thats thegood news. The bad news is that the dairy industry has done a terrific job of promoting

dairy products as the only adequate dietary source of calcium. Dairy products are far from the solution, and may very well be a cause of the problem.

Adequate amounts of calcium are necessary for high-level health. Calcium is necessaryfor heart muscle contraction, skeletal muscle contraction, the action of most hormones inthe body, and bone strength. Because calcium is so crucial to survival, our bodies
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carefully regulate the amount of it in our blood. We even have a back-up reservoir of calcium available at all timesour bones.

Calcium reservoirTo keep a constant level of calcium in the blood, our bodies are continually adding and

removing calcium to the bloodstream. When there is extra calcium in the bloodstream,the body removes some of it and stores it in the bones. When there is too little, the bodytakes calcium from the bones and adds it to the bloodstream.

It works like this: When serum calcium levels fall, a hormone called parathyroidhormone, produced in four small glands attached to the thyroid gland, stimulatesosteoclasts. The osteoclasts break down bone and release calcium. When calcium is

plentiful, a hormone called calcitonin, made in the thyroid, stimulates osteoblasts, cellsthat store calcium by building bones.

For a long time, scientists thought this was the whole storyif you dont get enough

calcium, your body will withdraw calcium from your bones, and eventually you willdevelop osteoporosis. But the story is turning out to be more complex.

High intake, weak bonesMuch to the chagrin of the dairy industry, scientists have discovered that more calciumisnt better. In fact, the countries around the world with the highest rates of calciumintakeincluding the U.S. and Canadahave the highest rates of hip fractures amongthe elderly. The largest source of calcium in these countries is dairy products. In one of the largest studies of diet and health ever undertaken in the U.S., the Nurses HealthStudy, researchers found that high total calcium intake and milk consumption did not

protect against osteoporotic fractures.1 In a comprehensive review of all studies of dairy

intake and bone strength in 2000, researchers concluded that the body of scientificevidence appears inadequate to support a recommendation for daily intake of dairy foodsto promote bone health in the general U.S. population.2

Japanese women have lower total calcium intake than U.S. women at about 400-500 mg per day from soy products, vegetables, and small fish bonesyet they have lower rates of hip fracture despite having smaller bones.3 So high calcium intake alone, especially whenthe source of calcium is dairy products, does not ensure bone strength. Even bone mineralcontent (the amount of calcium- phosphate in bones) does not necessarily determine risk of fracture. This mineral-content finding is very important because physicians currentlyassess risk for bone fractures using x-ray measurement of bone mineral content.

Building strong bonesAdopting an Eat to Live-style diet is crucial for strong bones. Vegetables, beans, fruits,and nuts are the best sources of calcium, potassium, vitamin K, magnesium, andvegetable protein, as well as the phytochemicals (such as isoflavones) and micronutrientsthat are gaining recognition as important for bones. Keep in mind that the current U.S.daily calcium recommendation of 1200 to 1500 mg for postmenopausal women is anattempt to offset the ill effects of the typical vegetable-and nutrient deficient American


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diet, which is laden with salt, caffeine, and junk-food. Sadly, even this attempt to floodthe body with extra calcium to compensate for poor nutrition has not been proven to

prevent fractures.4 (Check out Get Some Veggie Calcium for good sources of calcium.)

Weight bearing and resistance exercise are extremely important to bone strength, and can

reverse osteoporosis even in postmenopausal women.5 Walking is particularly importantto hip bone strength.

Vitamin D might be more important to bone strength than calcium. Vitamin D promotesthe uptake of calcium from the intestines and also increases bone building. The sun is

probably our best source of vitamin D. Vitamin D needs are probably met with 15minutes of exposure in the middle of the day three times per week. Many studies haveshown that vitamin D supplements increase bone density in postmenopausal women;however, a recent comprehensive review of the subject determined that the efficacy of vitamin D supplements had not been proven.6 If you havent had your vitamin D bloodlevels checked, you might consider it so that you can increase your sun exposure or add a

supplement if necessary.

Avoid toxins. The ingestion of animal proteinespecially when combined with lowvegetable intake, steroids, caffeine, cigarettes, vitamin A (retinolfound only in animalfoods, fortified foods, and vitamin pills), and salt all have been associated with weak

bones.

Rather than letting your bones weaken as you age, you can strengthen them and keepthem strong.

Our bones are composed of a porous network of calcified bridges called a trabecula

network, which under an electron microscope looks like the inside of a sponge. Thisnetwork of connecting bridges continually breaks and rebuilds with normal wear and tear as a result of the activities of daily living.

When use and weight-bearing activities are increased, many of these bridges break, butthen are rebuiltthicker and stronger. In fact, they grow and thicken in response to thestresses placed on them. With little muscle stress on the joint, they lose density and

become thin and fragile. The strength and density of bone over time is directly proportional to the muscle strength moving that fulcrum. Just as muscles build withregular exercise, the bone strengthens too, right along with the muscle. In fact, a good testfor bone strength is muscle strength.

Unfortunately, most women in America and other modern countries have relativelysedentary lives. Even women who do regular exercise and walk are susceptible, sincemost popular exercises do not adequately stress the spine with enough stimuli for bonegrowth. Having a healthy, erect spine is extremely important for digestion and overallhealth. Activities that exercise and strengthen the spine include digging, shoveling,carrying toddlers, using rowing machines, and doing back extension exercises. Scientific
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studies also have demonstrated that wearing a weighted vest can have a powerful protective effect.1

Because vitamin D increases the absorption of calcium in the gastrointestinal tract andstimulates osteoblastic (bone-building cells) activity, vitamin D has been generating lots

of interest lately in the medical literature. Borderline low levels of vitamin D have beenfound to be very common in the United States and Canada.

Medical studies show taking vitamin D is more effective than taking extra calcium for osteoporosis. In a recent 3-year prospective multi-center study, 622 women withosteoporosis, 50 to 79 years of age, who had one or more compression fractures of their spine, were randomly assigned to receive 25 mcg of calcitriol (900 IU vitamin D) or 1000mg calcium for three years. In the third year, the vitamin D-supplemented group had 9fractures per 100 women, and the calcium-treated group had 31.5.The difference in effectalso was evident after two years.

The take-home message here is that curtailing habits that cause calcium wasting in theurine and monitoring vitamin D for adequate intake are more important than taking extracalcium. Attention to vitamin D status is most critical in those not getting regular sunshine. The most effective prescription for preventing and reversing osteoporosisinvolves diet-style modifications, extra vitamin D intake, and an effective exercise

program.

OsteoarthritisDescriptionMost important nutrients: Beta-carotene, Vitamin C, Vitamin D, Vitamin E,Niacin, Omega 3 fatty acids, BoronMost important foods: Fish, GingerAvoidances:

Osteoarthritis - Day 1

Breakfast

Pineapple orange papaya salad Poached eggs over steamed collard greens

Snack

8 fl oz plain yogurt 1 tbsp flax seed

1 tbsp walnuts 1 tbsp dried figs tsp ginger

Lunch

Warm quinoa salad Asparagus salad

Nutritional Profile

Calories 1874

Calories from fat 35%

Fiber 40 g

Vitamin A-RE 362%

Beta-carotene 15514 mcgVitamin C 380%

Vitamin D 122%

Vitamin E 117%

Niacin 255%
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Dinner

Shiitake mushroom soup Baked chicken breast with honey mustard sauce

Healthy mashed sweet potatoes

Boron 1.5 mcg

Omega 3 EFA 4.1 grams


Breakfast

Perfect oatmeal 1 cup fruit salad:

o papayao blueberrieso sprinkled with grated fresh ginger

Snack

Rice cake 1 tbsp sunflower seed butter Small pear

Lunch

Golden squash soup Soy bean and fennel salad

Dinner

Baked salmon and walnut patties with red bell peppersauce Sauteed greens cup quinoa

Blackberry tart

Nutritional Profile

Calories 1810


Fiber 44 g

Vitamin A-RE 308%

Beta-carotene 13886 mcg

Vitamin C 487%

Vitamin D 168%

Vitamin E 122%

Niacin 100%

Boron 2.8 mcg



Breakfast

1 cup fruit salad:o cantaloupeo strawberrieso papayao sprinkled with fresh grated ginger

8 oz yogurt 1 tbsp flax seeds Whole wheat toast 1 tbsp almond butter

Snack

Nutritional Profile

Calories 1888

Calories fromfat 33%

Fiber 41 g

Vitamin A-RE 114%


Vitamin C 275%
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Banana cup trail mix:

o sunflower seedso pumpkin seedso raisins

Lunch

Tuna salad:o 1 cup romaineo cup collard greenso cup turnip greenso cup navy beanso cup sliced fennelo cup pearo 1/8 cup onionso Small can tunafish packed in water

Dressing:o 1 tbsp flax seed oilo tsp turmerico tsp cumino 2 rye crackers

Dinner

4 oz roasted turkey breast 1 cup quinoa 1 cup winter squash puree

6 asparagus spears with 1 tbsp sesame seeds

Vitamin D 89%

Vitamin E 164%

Niacin 228%

Boron .08 mcgOmega 3 EFA 10.46 grams


Breakfast

Breakfast shake:o 1 cup soymilko 4 oz yogurto cup blueberrieso frozen bananao 1 tbsp flax seedso tbsp flaxseed oil

1 rice cake 1 tbsp sunflower butter

Snack

Fruit salad:o 2 kiwifruito cup raspberries

Lunch

Nutritional Profile

Calories 1998


Fiber 49 g

Vitamin A-RE 327%


Vitamin C 500%

Vitamin D 51%

Vitamin E 167%

Niacin 200%

Boron --- mcg


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3 oz baked marinated tempeh 1 cup brown rice 2 cups healthy sauted veggies:

o chardo broccolio collards with 1 tsp garlic

Dressing:o 1 tbsp olive oilo 1 tbsp sesame seedso 1 tsp ground gingero 1/8 tsp cayenne pepper

Dinner

6 oz halibuto topped with 4 shrimpo cup pineapple-papaya salsa

cup barley 1 cup brussel sprouts

1 small sweet potato with 1 tbsp sliced almonds


Osteoarthritis

Osteoarthritis, a crippling joint disease that affects more than 20.7 millionpeople in the United States, occurs when inflammation damages jointlubrication and cartilage.

Although early symptoms may be mild or barely noticeable, the conditioneventually progresses causing a great deal of pain. Osteoarthritis also leadsto disability as the damaged joint is no longer able to move properly.

Fortunately, there are certain nutrients and foods that may help to halt theprogression osteoarthritis before it becomes severe as well as helping toreduce the pain and inflammation associated with it.

Eat more

Cold water fish such as salmon, tuna, herring, mackerel and halibut. Organically grown fruits and vegetables Nuts and seeds Whole grains Ginger

Avoid highly refined products such as white rice, white bread and whitepasta, excessive saturated fats and foods which contain trans fats.

Description Dietary Causes Nutrient Needs
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Nutrient Excesses Recommended Diet References

Description

What Is Osteoarthritis?

Osteoarthritis, one of the most common forms of arthritis in the UnitedStates, is the 8th leading cause of disability in the world. Over 20.7 millionAmericans are afflicted with the condition, and approximately 100,000 areunable to walk as a result.

In 1989 alone, around 30,000 hip replacement and 70,000 knee replacementsurgeries were done to treat osteoarthritis. The pain and disability caused byosteoarthritis has a major impact on the lives of those suffering with thisdisease.

Being unable to move certain joints properly can make tasks of normal livingvery difficult. Osteoarthritis patients may be unable to walk up stairs, buttontheir clothes, or even brush their hair, things that most people take forgranted. Slowing the progression of this condition through simple dietarychanges may help prevent these long-term consequences.

Symptoms

Osteoarthritis symptoms are initially very mild. In fact, researchers havefound that only about 50% of people with early signs of osteoarthritis on X-ray have noticeable symptoms.

The symptoms may worsen over time as the condition progresses and the joint damage continues. Osteoarthritis tends to occur mainly in the hands,knees, elbows, hips, and spine.

Symptoms of osteoarthritis include:

Grinding sensation during joint movement Pain with joint movement Joint stiffness Joint swelling Deformity of the joint (usually occurs later in the condition) Reduced mobility of the joint A feeling of joint instability

Many osteoarthritis patients take pain-killers such as aspirin, acetaminophen,or ibuprofen. While these may be helpful for temporarily reducing pain, theyhave not been shown to prevent the progression of osteoarthritis, and mayeven cause the damage to progress more quickly. In addition, some of these
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medications can be rough on the digestive tract, leading to symptoms thatrange from mild stomach upset to ulceration and bleeding.

If you're taking pain-killers and start to experience severe stomach pain,vomiting, vomiting of blood, generalized weakness, a change in the color of your stools to very dark or black, or if you see blood in your stools, youshould contact your doctor immediately as these may be signs of bleeding of the digestive tract, which can be a serious medical condition.

The Disease Process

What causes a normal, healthy joint to become swollen, painful anddebilitated? The process may be a slow and gradual one that takes manyyears to have an impact.

A healthy joint, the part of the body that connects two bones, containsseveral main components. The first component includes the ends of the

bones themselves. These bone endings are lined with a rubbery, cushionymaterial called cartilage , which prevents bones from grinding or smashingtogether. Since cartilage is flexible, it can withstand the pressure of jointmovement and bounce right back into its original form without any damage.

The outside of the joint is wrapped in connective tissue. The connectivetissue is strong enough to hold the joint together, but thin and light enoughto allow the joint to move properly. Lining the inside of the joint is thesynovial membrane , a thin layer of cells that produce fluid to keep the jointmoist and lubricated, so it can glide and move easily.

The synovial fluid also provides the cartilage cells with oxygen and nutrientssince the joint itself contains no blood vessels. (In all other parts of the body,nutrients and oxygen are delivered via the bloodstream.)

In a joint stricken with osteoarthritis, however, an inflammatory process istaking place. When inflammation occurs, the cells of the joint, including thesynovial and cartilage cells, produce chemicals that lead to an increase infree radicals. These free radicals are dangerous substances that can attackand damage the cartilage and synovial membrane of the joint.

As time goes by, the cartilage starts to wear away, the synovial membranedries out, and the synovial fluid disappears. With the cartilage gone, the endsof the bones start to grind together. This causes the ends of the bone tobecome thicker and harder.

Eventually, the ends of the bones start to grow cysts and sharp, bony spikes,called osteophytes , that may stick out into the joint space and severelyhamper the movement of the joint. In the end, the joint is painful, unable tomove properly, and deformed from the inflammation and bony osteophytes.


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Causes

The exact cause of osteoarthritis is still considered to be unknown, thoughseveral theories exist as to what may happen to start the condition.Generalized osteoarthritis of the hands, knees, and spine seems to have agenetic component as it tends to run in families. However, genetics doesn'tseem to play a role in other forms of osteoarthritis and certainly isn't thewhole picture.

Osteoarthritis of the knees and hands seems to occur more commonly inpeople who are obese, though it is not clear why this is the case.Researchers think there may be certain hormones produced by fat cells thatmay lead to joint problems. It has been shown that obese people who loseweight, even as little as 10 pounds, can greatly reduce their risk of developing osteoarthritis and even reduce the pain of osteoarthritis.

Another possible cause of osteoarthritis is joint trauma. People who do a lot

of high-intensity exercise or who do activities that frequently injure their joints, like professional or competitive athletes, tend to wind up with thiscondition after a while.

Researchers believe that repetitive stress and injury to the joint eventuallyleads to inflammation that causes damage. Moderate exercise is beneficial,especially for those trying to lose weight, and is therefore recommended.Exercise that damages or causes pain in the joints, however, is excessive andshould be toned down.

Dietary Causes

A diet that is generally low in essential nutrients has been shown tocontribute to the development or progression of osteoarthritis. Basically, thistranslates to a diet high in refined products like white rice, white bread, whitepasta, and saturated and trans-fats , and low in nutrient-rich foods likevegetables, fruits, legumes, fish, whole grains, and lean meats.

Refined foods such as white rice and baked goods made from white flourhave been stripped of the vast majority of their nutrients. Although smallamounts of some nutrients, like certain B-vitamins, are added back in toprevent wide-spread deficiencies, this so-called "enrichment" is comparableto taking away a dollar and giving back two cents. Fatty foods like potato

chips or french fries are not only high in calories, but low in essentialnutrients.

Unfortunately, these refined and high-fat foods make up much of the"Standard American Diet" (appropriately abbreviated as SAD). Replacingthese refined, nutrient-poor foods with whole, healthy foods can help reducerisk of osteoarthritis.
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In addition, research studies have shown that certain nutrients, such asvitamin D , vitamin C , beta-carotene, and niacin , may be able to reduce theprogression of osteoarthritis. Consumption of foods rich in these nutrientsmay help delay or even prevent the disability that can occur from thiscondition.

Certain other nutrients, such as vitamin E , boron, niacinamide, and omega-3fatty acids , may actually help reduce the pain and swelling that comes withosteoarthritis. As a result, patients may be able to decrease their use of pain-killers, which can have nasty side-effects, by consuming healthy foods rich inthese nutrients.

Nutrient Needs

Foods That May Help Include:

Whole Foods

To nourish your joints, try a big bowl of steaming oatmeal sprinkled withcinnamon, add some raisins, diced apple, toasted pumpkin seeds, andchunks of banana. Wash it down with a tall glass of cold orange juice. Thisnutrient-dense fiber-rich breakfast can give you all the energy you need untillunchtime.

Instead of deli meat on white bread for lunch, treat your joints to a salad of mixed greens, diced carrot and tomato, a handful or two of nutty chickpeas,and some white meat chicken strips, topped off with an olive oil, balsamicvinaigrette dressing and a sprinkling of grated parmesan cheese. Add apeach or some melon or a cup of yogurt for a snack or two during the day.

Greasy fast food burgers and fries doused in sugar-laden ketchup for dinner?Not for your joints! They'll be pampered with fragrant brown rice, flaky bakedsalmon seasoned with a fresh garlic, rosemary sauce, and steamed sweetpotato, or butternut squash, and snow peas. To start, a crisp spinach saladtopped with walnuts and fresh romano cheese.

Contrary to popular belief, healthy food is not about bran muffins and celerysticks. There are many different whole foods, from vegetables to meats anddairy products, available these days that can help you pack in the nutrientsthat feed your joints.

Whole foods contain the nutrients necessary for joint health: vitamins suchas vitamin C , vitamin D , vitamin A , the B vitamins , vitamin K , and folic acid ;minerals like calcium , magnesium , selenium , zinc , and iron ; and otherbeneficial nutrients such as bioflavonoids and beta-carotene.

The best way to protect your joints is to eat a wide variety of nutritiousfoods. You have a much better chance of getting all the vitamins and
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minerals you need if your diet includes an assortment of different foods, thanif you eat the same thing every day. If you're trying to lose weight, nothingworks better than replacing the high fat, high sugar, high starch Americandiet with meals centered around fresh fruits, vegetables, whole grains,legumes, fish, and lean meats.

Fish

Remember that piece of succulent baked salmon? Evidence suggests that fishmay be helpful in osteoarthritis. Fish, especially cold water fish like salmon ,mackerel, halibut , herring, tuna , sardines, and cod, have high levels of omega-3 fatty acids . These omega-3 fats are used by the body to makesubstances that reduce inflammation.

Fish is also a wonderful and delicious source of essential protein, which isneeded for the repair of damaged joints. Some fish also contain vitamin D , acritical nutrient for strong, healthy bones that can help prevent the

progression of osteoarthritis. Eat fish often, as it may help ease thesymptoms of osteoarthritis as well as improve your overall health.

Ginger

Add some zest to your salad dressing with fresh ginger . Some people withosteoarthritis report that using ginger regularly helps reduce the pain andswelling in their joints. Ginger contains active components that stop the bodyfrom producing inflammatory substances that add to inflammation in the

joints.

A versatile spice that adds an exotic bite to any meal, ginger can transformpractically any dish from mundane to exceptional. Try mincing a sliver of fresh ginger for a topping on steamed vegetables, meats, fish, baked fruit,and fresh salads. While fresh ginger is the most flavorful, dried ginger mayalso be beneficial.

Nutrients in Food That May Help Include:

To Reduce the Risk or Progression of Osteoarthritis

Vitamin D

When osteoarthritis patients get plenty of vitamin D in their diets, their jointdamage progresses more slowly. In contrast, people who don't get enoughvitamin D, have more rapidly occurring joint damage, leading rapidly todisability. Vitamin D not only helps prevent the breakdown of cartilage, it'snecessary for rebuilding healthy cartilage and maintaining strong bones.Shrimp and fortified milk are two very good sources of vitamin D.

Vitamin C
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Vitamin C is a powerful antioxidant in the body. By neutralizing free radicals,vitamin C helps reduce inflammation and damage that occurs inosteoarthritis.

Vitamin C is also necessary for the production of healthy connective tissueand cartilage, and may even be able to help undo some of the damage thathas already been done. The osteoarthritis of patients who get plenty of vitamin C in their diets seems to progress more slowly compared to peoplewho have diets low in vitamin C.

Excellent food sources of vitamin C include broccoli, parsley , bell peppers ,strawberries, cauliflower, lemons , mustard greens, Brussels sprouts, papaya ,kale, cabbage, spinach, kiwifruit , cantaloupe, oranges, grapefruit , tomatoes,chard, collard greens, raspberries , peppermint leaves , asparagus, celery,fennel bulb , pineapple, and watermelon .

Beta-carotene

Beta-carotene is another powerful antioxidant. Like vitamin C, beta-carotenehelps destroy free radicals before they can cause excessive damage to joints.A diet rich in beta-carotene also helps slow the progression of osteoarthritis.

Fortunately, beta-carotene is easy to spot because it gives fruits andvegetables, such as apricots ,and carrots, their bright orange color.

Excellent food sources of beta-carotene include sweet potatoes , carrots, kale,winter squash, collard greens , chard, cantaloupe, mustard greens, romainelettuce, spinach, parsley, cayenne pepper , peppermint leaves, Brussels

sprouts, tomatoes , broccoli, asparagus, and apricots.Niacin

Niacin, also known as vitamin B-3 , plays many roles in the body and isneeded for healthy cells. Although researchers aren't quite sure why, a diethigh in niacin may help protect people from ever developing osteoarthritis inthe first place. Some studies show that niacin may cut osteoarthritis risk inhalf.

Excellent food sources of niacin include crimini mushrooms and tuna. Verygood sources include salmon, chicken breast, asparagus, halibut and

venison.

To Reduce the Pain of Osteoarthritis

Vitamin E

Vitamin E , like vitamin C and beta-carotene, is yet another antioxidant thathelps eliminate damaging free radicals. Vitamin E is also very good at
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reducing inflammation, which contributes to the problems in osteoarthritis.Studies have shown that osteoarthritis sufferers with high intakes of vitaminE report a significant reduction in their pain. Many are even able to reducethe amount of pain-killers they need to take. Mustard greens , chard , turnipgreens, and sunflower seeds are a few excellent sources of vitamin E.

Boron

In Australia, boron has been a very popular remedy for osteoarthritis formany years. It's especially useful in areas where the diet tends to be low inboron, which can occur if the soil contains low levels of boron, or if peopleare eating diets that are low in boron-rich foods.

Boron is needed in the body for the production of many substances, includinghormones and vitamin D, both of which are very important for healthy bonesand joints.

Omega-3 Fatty Acids

Omega-3 fatty acids have been shown in some studies to reduce the pain of osteoarthritis. When the diet contains plenty of these essential fats, the cellsmake less of the pro-inflammatory substances and more of the anti-inflammatory substances.

By reducing inflammation, omega-3 fats help prevent the damage to thecartilage and connective tissue that usually occurs in osteoarthritis.

Excellent food sources of omega-3 fatty acids include flax seeds , walnuts andsalmon.

Niacinamide

Some studies show that niacinamide can improve symptoms of osteoarthritisand may be able to reduce the amount of pain-killers needed. To date,researchers are not sure exactly how niacinamide, which has many differentfunctions in the body, is able to help with osteoarthritis.

Nutrient Excesses

Substances to Avoid

Vitamin A and Retinoids

People who take very high doses of vitamin A for a very long time tend towind up with joint pain and damage that looks a lot like osteoarthritis. Thesehigh doses could not be obtained from diet alone and are also much higherthan doses that appear even in multivitamins.
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This means that only people who are taking extra vitamin A as a supplementare at risk. Also, certain medications typically used for skin conditions aremade from vitamin A-like chemicals called retinoids . Retinoids may alsocause joint damage. If you are taking medications like these, you may wantto talk to your doctor about the possibility of joint problems with long-termuse.

Iron

Genetic hemochromatosis is a hereditary condition that occurs mostly inpeople of Caucasian descent. People with this condition absorb more iron than they need and then store it in their bodies. As much as 80% of peoplewith this condition, also called iron-overload, develop osteoarthritic jointchanges if they consume too much iron. If they continue to get too muchiron, it can build up in their organs and cause severe organ damage.

Typically, the amount of iron found in a healthy, balanced diet is not enough

to cause problems. However, iron supplements should be avoided by personsat risk for osteoarthritis, even iron-containing multivitamins, unless a doctorhas specifically recommended iron supplementation.

Recommended Diet

What should you eat if you have osteoarthritis or are trying to avoid gettingit? The best advice is to eat a varied diet high in necessary nutrients.

A diet filled with a variety of fresh fruits and vegetables, beans and peas,nuts and seeds, whole grains, lean meats, and especially cold-water, wild-caught fish is sure to provide you with all the nutrients that are important inmaintaining overall health and flexible, healthy joints.

This way of eating may help halt the progressive damage of osteoarthritis, aswell as help you cut back on the amount of pain-killers you need by reducingpain and swelling.

Throwing a little bit of ginger into your cooking for some added zip mayfurther reduce symptoms.

Stop giving your joints SAD (Standard American Diet) foods. Leave therefined white flour, fat-laden products on the shelf, and switch to foods richin the nutrients your joints need. Flexibility in your diet will translate toflexibility in your joints.
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Hypertension (high blood pressure)

Hypertension is a consistent elevation in blood pressure. "Blood pressure"signifies the resistance produced each time the heart beats and sends bloodcoursing through the arteries. Between beats, the heart relaxes, and bloodpressure drops. The lowest pressure is referred to as the diastolic pressure.The peak pressure exerted by this contraction is the systolic pressure. Anormal blood pressure reading for an adult is: 120 (systolic) / 80 (diastolic).

Hypertension is a major risk factor for a heart attack and is generally

regarded as the greatest risk factor for a stroke. Hypertension (high bloodpressure) is aptly called "a silent killer," because people are often unaware of having hypertension until a stroke or heart event brings the message home.

The physiological changes related to hypertension can frequently be relatedto lifestyle patterns that are easily modifiable. For example, being overweightmay contribute to hypertension, because it increases the work required bythe heart. Making healthy eating choices can be an important, easy andenjoyable step towards maintaining healthy blood pressure levels.

Eat more

Cold water fish such as salmon, tuna, herring, mackerel and halibut for their beneficialomega 3 fatty acid

Onions and garlic Olive oil Celery Organically grown fruits and vegetables, especially leafy greens and cruciferous vegetables

such as broccoli, cauliflower and cabbage Whole grains Legumes Potatoes

Avoid saturated fat, sugar, caffeine, alcohol, excess sodium

Description Dietary Causes Nutrient Needs Nutrient Excesses Recommended Diet References

Description
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What is Hypertension?

Elevated blood pressure is a major risk factor for a heart attack and isgenerally regarded as the greatest risk factor for a stroke. "Blood pressure"signifies the resistance produced each time the heart beats and sends blood

coursing through the arteries.

The peak pressure exerted by this contraction is the systolic pressure.Between beats, the heart relaxes, and blood pressure drops. The lowestpressure is referred to as the diastolic pressure. A normal blood pressurereading for an adult is: 120 (systolic) / 80 (diastolic).

High blood pressure is divided into different levels:

Borderline (120-160/90-94) Mild (140-160/95-104) Moderate 140-180/105-114) Severe (160+/115+)

Physicians are primarily concerned with diastolic pressure (the secondnumber in the blood pressure reading), but systolic pressure is alsoimportant. Individuals with a normal diastolic pressure (under 82 mm Hg)but elevated systolic pressure (over 158 mm Hg) have double the risk of death due to heart attack or stroke compared to individuals with normalsystolic pressures (under 130 mm Hg).

Blood pressure typically goes up as a result of stress or physical activity, butin a person with high blood pressure, is elevated even at rest.

Over sixty million Americans have high blood pressure, including more thanhalf of all Americans aged 65-74 years, and almost three-fourths of allAfrican-Americans in the same age group.

Most patients with high blood pressure are in the borderline-to-moderaterange, a group in which almost all cases of high blood pressure can bebrought under control through changes in diet and lifestyle. In fact, in casesof borderline-to-mild hypertension, healthful changes in diet and lifestyle(discussed below) have proven superior to drugs in head-to-headcomparisons.

In addition, in some people, the drugs typically prescribed to lower bloodpressure produce the very thing they are trying to prevent: a heart attack.Several well-designed long-term clinical studies have found that people whotake blood-pressure-lowering drugs (typically diuretics and/or beta-blockers)actually suffer from unnecessary side effects (e.g., fatigue, headaches, andimpotence), including an increased risk of heart disease.

Frequent Signs and Symptoms


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Usually none--blood vessels do not have nerves, so no symptoms are felt until the conditionbecomes severe

Typically discovered as part of a routine check up

A hypertensive crisis may be indicated by:

Headache, drowsiness, confusion Numbness and tingling in hands and feet Coughing blood; nosebleeds Severe shortness of breath Vague but intense feeling of discomfort

Related Tests

Blood pressure screening (In addition to physicians' offices, blood pressure may sometimesbe checked at pharmacies, fire stations, and public health offices. There are also simplifiedhome systems.)

Blood lipids, blood triglycerides, blood insulin or oral insulin tolerance (Syndrome X testing)

Methionine loading test (for high homocysteine levels)

Dietary Causes

Sodium and potassium

Excessive consumption of dietary sodium (from table salt), coupled withdiminished dietary potassium , is a common cause of high blood pressure,especially in "salt-sensitive" individuals. Numerous studies have shown thatsodium restriction alone does not improve blood pressure control in mostpeople, but must also be accompanied by a high potassium intake.

In our society, only 5 percent of sodium intake comes from the naturalingredients in food. Prepared foods contribute 45 percent of our sodiumintake, 45 percent is added in cooking, and another 5 percent is added as acondiment. All the body requires in most instances is the salt that is naturallypresent in food.

Most Americans have a sodium-to-potassium ratio greater than 2:1, meaningthat most people ingest twice as much sodium as they do potassium.Researchers recommend a dietary sodium-to-potassium ratio of less than 1:5to maintain health. This is 10 times the average intake of potassium, yeteven this may not be optimal. A natural diet rich in fruits and vegetables can

produce a sodium-to-potassium ratio of under 1:100, as most fruits andvegetables have a sodium-to-potassium ratio of less than 1:50.

Calcium, magnesium, and vitamin C

Epidemiological and clinical studies have found numerous links betweeninadequate amounts of these three nutrients and high blood pressure.

Saturated fats
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A high intake of saturated fats has been conclusively linked to highcholesterol levels and atherosclerosis. These "hard" fats become incorporatedwithin the walls of blood vessels, which then lose their elasticity.

Essential fats

Population and autopsy studies have demonstrated that people who consumea diet rich in omega-3 essential fats from either fish or vegetable sourceshave the lowest degree of cardiovascular disease and, conversely, those whoconsume the least omega-3 essential fats have the highest degree of cardiovascular disease.

Sugar

A high intake of sugars in the diet is an almost sure ticket to increased bloodlipid and sugar levels, because sugars deplete the body of vitamins andminerals necessary for controlling lipid and sugar levels as well as for

protecting the blood vessels. Excess blood sugar can also cause directdamage to blood cells and arterial walls, an effect much like acceleratedaging.

Dietary fiber

Fiber in the diet is an absolute key in helping control blood levels of lipids andsugar, and a low dietary intake of fiber is associated with atherosclerosis (hardening of the arteries).

Caffeine and nicotine

Caffeine (and nicotine--another reason not to smoke) is a stimulant thatpromotes the body's stress response, releasing hormones that rapidly elevateblood pressure.

Alcohol

In susceptible individuals, even moderate alcohol consumption causes asteep rise in blood sugar and increases the production of free radicals, bothof which damage arteries and can contribute to chronically elevated bloodpressure.

Nutrient Needs

Essential fats

Over sixty double-blind studies have demonstrated that either fish oilsupplements or flaxseed oil, the two best sources of omega-3 essential fats,are very effective in lowering blood pressure. Fish oils have typicallyproduced a more pronounced effect than flaxseed oil because the dosage of fish oils used was quite high (equal to ten capsules daily).
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Flaxseed oil may be the better choice for lowering blood pressure, especiallywhen cost-effectiveness is considered. Along with reducing the intake of saturated fat, 1 tablespoon per day of flaxseed oil should lower both thesystolic and diastolic readings by up to 9 points.

Potassium

Several studies show that potassium supplementation alone can producesignificant reductions in blood pressure in hypertensive subjects. Typically,these studies have utilized dosages ranging from 2.5 to 5.0 grams of potassium per day. Significant drops in both systolic and diastolic valueshave been achieved.

In one study, potassium supplementation lowered systolic blood pressure anaverage of 12 points and diastolic blood pressure an average of 16 points.Potassium supplementation may be especially useful in the treatment of highblood pressure in persons over the age of sixty-five, who often do not fully

respond to blood-pressure-lowering drugs.

In one double-blind study of eighteen patients whose average age was 75,with a systolic blood pressure of greater than 160 mm Hg and/or a diastolicblood pressure of greater than 95 mm Hg, those who received potassiumchloride (supplying 2.5 grams of potassium) each day for four weeksexperienced a drop of 9 points in systolic and 7 points in diastolic pressure-comparable results to drug therapy without its negative side effects.

Using foods or food-based potassium supplements to meet the human body'shigh potassium requirements rather than pills is suggested, since potassiumsalts can cause nausea, vomiting, diarrhea, and ulcers when given in pillform at high dosages. These effects are not seen when potassium levels areincreased through diet only.

Caution: Check with your physician before taking potassium. Individuals withkidney disease do not handle potassium in the normal way and are likely toexperience heart disturbances and other consequences of potassium toxicity.

Potassium supplementation is contraindicated when using a number of prescription medications, including digitalis, potassium-sparing diuretics, andthe angiotensin-converting-enzyme-inhibitor class of blood-pressure-loweringdrugs. People with kidney disease or severe heart disease should not takemagnesium or potassium unless under the direct advice of a physician.

Magnesium

Magnesium is second only to potassium in its concentration within cells andinteracts with potassium in many body systems. Studies suggest that lowlevels of potassium within cells may be the result of low magnesium intake.
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Population studies provide considerable evidence that a high intake of magnesium is associated with lower blood pressure. Numerous studies havedemonstrated an inverse correlation between water "hardness" (water highin magnesium) and high blood pressure. Where magnesium content of thewater was high, there were fewer cases of high blood pressure and heartdisease.

Similarly, studies have found that when dietary intakes of magnesium werehigh, blood pressure was lower. Magnesium supplementation is particularlyhelpful in lowering blood pressure if:

An individual is taking a diuretic, since diuretics cause magnesium depletion. High blood pressure is associated with a high level of renin, an enzyme released by the

kidneys that leads to the formation of chemicals that cause blood vessels to constrict andblood pressure to increase.

An individual has elevated intracellular sodium or decreased intracellular potassium levels(as measured by red blood cell studies).

Absorption studies indicate that magnesium is easily absorbed orally,especially in the citrate form. In addition, while inorganic magnesium salts(like magnesium oxide) often cause diarrhea at higher dosages, organicforms of magnesium (magnesium citrate or aspartate) generally do not.

Vitamin C and flavonoids

Studies have shown that the higher the intake of vitamin C the lower theblood pressure. One of the ways vitamin C helps keep blood pressure in thenormal range is by promoting the excretion of lead.

Chronic exposure to lead from environmental sources, including drinkingwater, is associated with high blood pressure and increased cardiovascularmortality. Areas with a soft water supply have higher lead concentrations indrinking water due to the acidity of the water. Soft water is also low incalcium and magnesium-two minerals that protect against high bloodpressure.

Flavonoids (which co-occur naturally with vitamin C in many colorful fruitsand vegetables) support the antioxidant actions of vitamin C and helpstrengthen and protect the inner lining of blood vessels.

Vitamin E

Of all the antioxidants, the fat-soluble antioxidant, vitamin E may offer themost protection against hardening of the arteries because it is easilyincorporated into the LDL-cholesterol molecule where it prevents free radicaldamage. Vitamin E not only reduces LDL peroxidation, but it also improvesplasma LDL breakdown, inhibits excessive platelet aggregation, increasesHDL-cholesterol levels, and increases the breakdown of fibrin, a clot-formingprotein.
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Coenzyme Q10

Coenzyme Q10 or CoQ10 is an essential component of the mitochondria-thefactories where energy is produced in our cells. Although CoQ10 can besynthesized within the body, deficiency has been found in 39% of patientswith high blood pressure.

In several studies, CoQ10 has been shown to lower blood pressureapproximately 10% in patients with hypertension; however, not until afterfour to twelve weeks of therapy. CoQ10 seems to lower blood pressure bylowering cholesterol levels and stabilizing the vascular system via itsantioxidant properties. These actions reduce resistance to blood flow throughthe arteries.

Vitamin B3 (niacin)

Niacin is extremely important for controlling blood lipid levels and for proper

metabolism of carbohydrates and fats. Timed-release niacin may beemployed to avoid flushing. Liver toxicity may occur with high doses of niacin.

Folic acid, vitamins B6 and B12, and choline

These B-complex-related vitamins make significant contributions to thenormal function of the innermost layer of the blood vessels, which isnecessary for maintaining normal blood pressure. They are also necessary forour bodies to be able to metabolize homocysteine into other, usefulcompounds. An intermediate product of normal cellular metabolism,homocysteine accumulates-if not converted into methionine or cysteine via

the action of folic acid and vitamins B12 and B6-and can damage the bloodvessels, keeping them in a constant state of injury.

In addition to its role in clearing homocysteine, folic acid (also called folate)is an essential performer in the intricate biochemical dance through whichour blood vessels are instructed to be more elastic, to dilate and relax.

Folate plays a role in blood vessel tone because it affects the production of one of the most important agents controlling blood vessel elasticity-nitricoxide. Nitric oxide, which is produced in the vascular endothelium (the liningof the blood vessels), is made from the essential amino acid (protein building

block), arginine.In the endothelium, arginine is converted into citrulline through the action of an enzyme called endothelial nitric oxide synthase or eNOS for short. Thisprocess is brought about through the action of a coenzyme calledtetrahydrobiopterin. And tetrahydrabiopterin is made in the body through apathway that requires folate in the form in which it is active in the body,which is called 5-methyltetrahydrofolate or 5MTHFR.
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Without adequate folate, 5MTHFR cannot be produced. Without 5MTHFR,tetrahydrabiopterin cannot be produced. And without tetrahydrabiopterin, theprocess through which cirtuline is converted into NO cannot occur. WithoutNO, our blood vessels fail to dilate properly. This is one of the primaryreasons why diets rich in folic acid, such as the Mediterranean and DASHdiets, are able to lower high blood pressure as effectively as first generationhypertensive drugs.

Folic acid is so important for cardiovascular function that a major 1995 studyconcluded that 400 micrograms per day of folic acid could prevent 28,000cardiovascular deaths per year in the United States. The average daily intakeof folic acid is 280 to 300 micrograms, about half of which is absorbed.

Research published in the January 2005 issue of JAMA , the Journal of theAmerican Medical Association, continues to underscore how important a dietcentered around folate-rich leafy greens, cruciferous vegetables and legumesis for healthy blood pressure.

Researchers at Harvard Medical School and Brigham Young Women's Hospitalin Boston, Massachusetts, worked together to conduct two very largeprospective studies, one of 93,803 younger women (27 to 44 years) and asecond including 62,260 older women (43 to 70 years). Both groups weredrawn from women in the Nurses Health Study. All study participants werefree of hypertension when the research began, and both groups of womenwere followed for 8 years.

The results: Women consuming high amounts of folate (dietary folate plusfolic acid-containing supplements) had a significantly decreased risk of

hypertension.

Younger women getting at least 800 micrograms of folate daily had a 45%lower risk of developing high blood pressure compared to women consumingless than 200 micrograms per day.

Older women who consumed at least 800 micrograms of folate daily had a39% lower risk of developing hypertension.

Another study published in the May 2005 Journal of the American College of Cardiology suggests folate's effects are so powerful it can even be used invery high doses to acutely lower blood pressure in men and women withcoronary artery disease.

Though small, this was a very good study-a double-blind, placebo-controlled,crossover trial that involved 13 men and one woman with significantcoronary artery disease (>50% stenosis in at least one coronary artery).

Giving these subjects high dose folic acid (30 mg in two divided doses, 10-12hours and 1 hour before testing) effectively lowered their blood pressure (5-


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mm Hg) and significantly increased blood flow to the heart by 49%, anddilator reserve (the difference between peak blood flow to the heart andresting blood flow to the heart) by 83%! Folate is abundant in a wide varietyof vegetables. Excellent sources include leafy greens ( romaine lettuce ,spinach , collard greens , mustard greens ), cruciferous vegetables ( broccoli ,cauliflower ), and lentils . Very good sources include most beans ( black ,garbanzo , pinto , navy , green beans ), Brussels sprouts , celery , red bellpeppers summer squash , cabbage and fennel .

Substances and conditions that can negatively affect folic acid, vitamin B12 ,and vitamin B6 status include methotrexate, phenytoin, theophylline,dopamine, Isoniazid, tartrazine (yellow dye #5), insufficient stomach acid,intestinal flora imbalances, diarrhea, and smoking.

L-arginine

L-arginine is a common amino acid from food, but its importance increases in

those with hypertension. In the body (specifically within those hard-workingblood vessels) it is converted into nitric oxide, a chemical that helps keep theinner walls of blood vessels smooth and normally allows blood vessels torelax (among many other extremely important functions).

Individuals with hypertension have a harder time maintaining normal nitricoxide levels, which may also relate to other significant health issues such asdiabetes and heart problems. The kidneys are particularly sensitive to thelevels of l-arginine, nitric oxide, and related chemicals. Stressful experiencesand aging may also result in lower l-arginine levels.

Dietary intake levels of l-arginine vary considerably, but they range from 1 toover 4 grams per day. The consumption of nuts, which contain relatively highlevels of arginine, has a very strong negative correlation to the risk of coronary events.

Soy flour, wheat bran, hazelnuts, and walnuts all contain high levels of botharginine and folic acid. Fish contains high levels of arginine and essential fats.A major source of dietary arginine in the Western diet is meat; however,meat also contains high levels of saturated fats as well as methionine, theprecursor to homocysteine. Soy flour, wheat bran, and most nuts containrelatively low levels of methionine. It is advisable to limit arginine intake inthose with active or latent herpes simplex or herpes zoster infections.

Extra Virgin Olive Oil

It's likely the abundance of polyphenols in extra virgin olive oil, rather thanits monounsaturated fatty acids, are responsible for its well knowncardiovascular benefits.
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Research conducted by Dr. Juan Reno and colleagues at the Reina SofiaUniversity Hospital, Cordoba, Spain, and published in the November 2005issue of the Journal of the American College of Cardiology , investigated theeffects of virgin olive oil on endothelial function in 21 volunteers with highcholesterol levels.

The endothelium, although just a one-cell thick layer of flat cells that linesthe inner wall of all blood vessels, may be the critical player in cardiovascularhealth. Among its many functions, the endothelium orchestrates themechanics of blood flow, and regulates blood clot formation and the adhesionof immune cells to the blood vessel wall (one of the first steps in theformation of plaque).

Normally, after a meal, endothelial function is impaired for several hours.Blood vessels become less elastic promoting a rise in blood pressure, andblood levels of free radicals potentially harmful to cholesterol (lipoperoxidesand 8-epi prostaglandin-F2) increase.

But when the subjects in this study ate a breakfast containing virgin olive oilwith its normal high phenolic content (400 ppm), their endothelial functionactually improved, blood levels of nitric oxide (a blood vessel-relaxingcompound produced by the endothelium) increased significantly, and farfewer free radicals were present than would normally be seen after a meal.

When they ate the same breakfast containing the same type of virgin olive oilwith its phenolic content reduced to 80 ppm, the beneficial effects werevirtually absent, and concentrations of cholesterol-damaging free radicalsincreased. The results of this study underscore the importance of knowing

how to select, store and serve your olive oil to maximize its polyphenolcontent. For all the information you need, see our How to Select and Storesection in Olive oil .

Kukoamines-Phytonutrient Compounds in Potatoes

UK scientists at the Institute for Food Research have identified bloodpressure-lowering compounds called kukoamines in potatoes. Previously onlyfound in Lycium chinense , an exotic herbal plant whose bark is used to makean infusion in Chinese herbal medicine, kukoamines were found in potatoesusing a new type of research called metabolomics.

Until now, when analyzing a plant's composition, scientists had to know whatthey were seeking and could typically look for 30 or so known compounds.Now, metabolomic techniques enable researchers to find the unexpected byanalyzing the 100s or even 1000s of small molecules produced by anorganism.

"Potatoes have been cultivated for thousands of years, and we thoughttraditional crops were pretty well understood," said IFR food scientist Dr Fred
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Mellon, "but this surprise finding shows that even the most familiar of foodsmight conceal a hoard of health-promoting chemicals." Another good reasonto center your diet around the World's Healthiest Foods!

In addition to potatoes, researchers looked at tomatoes since they belong tothe same plant family- Solanaceae -as Lycium chinense . Metabolomic assaysalso detected kukoamine compounds in tomatoes. The IFR scientists foundhigher levels of kukoamines and related compounds than some of the othercompounds in potatoes that have a long history of scientific investigation.However, because they were previously only noted in Lycium chinense ,kukoamines have been little studied. Researchers are now determininingtheir stability during cooking and dose response (how much of thesecompounds are needed to impact health).

Nutrient Excesses

Excessive intakes of particular nutrients are clearly related to the

development of hypertension; generally, the greater the quantity in whichthese nutrients appear in foods, the more these foods are processed. Themost significant excesses include:

Calories contribute to excess weight and a greater burden of disposing of unnecessarynutrients into circulating blood lipids and body fat.

Saturated fats, which may be deposited into circulating blood lipids and in the delicate innerlayers of blood vessels, decreasing their elasticity, integrity, and healing capacity.

Sodium-because it is added to foods, i t frequently occurs in a much higher proportion thanminerals (especially potassium and magnesium) that help balance the actions of sodium inthe body.

Another increasingly important possibility is the ingestion of heavy metalsand other toxins that affect the function of the blood vessels. Significantamong these are lead, mercury, and cadmium.

Lead can occur in high levels in tap water, in old, peeling paint, and aftersanding wood floors. Mercury can occur in high levels in some types of fishand is also present in amalgam tooth fillings.

Cadmium can occur in high levels in air near highways and is also present insome batteries. These heavy metals are difficult for the body to excrete, andcan remain in the body and affect function for years.

Recommended Diet

Relationships Found between Food Groups and High Blood Pressure

In research published in the December 2005 issue of the American Journal of Clinical Nutrition , Lyn Steffen and colleagues from the University of Minnesota, looked at possible associations between the risk of developinghigh blood pressure in young black and white men and women and a diet

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