What does this mean for you & me? Is calcium good or not? Is there a specific population or demographic that could benefit more or sustain greater risk? As much as we'd like to be able to simplify complicated studies in to 15 second sound bites, it's not going to happen any time soon. As we gain more & more knowledge, we'll get into a better situation to put the blocks in place. Until then, dietary calcium seems like a safe bet. But as for calcium supplementation, the jury's still out. It could go either way. Stay tuned!
Bottom line, I haven't found anything bad associated with the Mediterranean diet, aside from the fact that I can't trademark it and make a profit. Therefore, there's no true commercial or capitalistic motive in promoting it, unlike all the other fad or better known diets out there. So I have nothing to gain by telling you to eat this way but you have everything to gain!
It's taking me a while to get caught up on my journal reading (which has been described as drinking from a fire hydrant). In the process, I stumbled, not unlike a blind squirrel finding a nut, a cross-sectional, longitudinal study published early online last month in the Journal of Clinical Endocrinology & Metabolism in which the authors concluded that body composition affects hormone levels but not vice versa. Apparently the authors followed 821 men for close to 5yrs after initial measurements of hormone status and body composition via dual energy xray absorptiometry were performed. Because no change in body composition was noted over this period of time, they concluded that body composition affects hormone levels but not the other way around. In other words, they claim that the chicken laid the egg.
Granted, I'm not any where near their level of expertise but I beg to differ. While baseline body composition may affect hormone levels, there's also plenty of evidence that hormone levels will affect body composition. For instance, those men who receive androgen deprivation therapy have a tendency to gain weight, especially central adiposity, while losing muscle mass. Furthermore, a randomized controlled study published 3yrs ago in the same journal showed that supplementing low to borderline low testosterone levels in frail elderly men lead to an increase in lean body mass & decrease in fat mass. In other words, this study suggests that the egg hatched the chicken.
Bottom line, life's complicated and our bodies even more so. It would appear that we can accept ourselves for what we are (body composition affects hormone levels) or we can do something about ourselves if we're not satisfied (hormone levels affect body composition). What you choose to do is obviously up to you. Just remember that this isn't a do it yourself project, if you elect to boost your testosterone level.
The authors arrived at their conclusions after finding 89 fair-to-good quality trials in which both SERMs reduced risk of invasive breast cancer w/tamoxifen getting the edge over raloxifene but at the cost of the above noted complications. Of note, taking one of two SERMs did not reduce either cancer-specific nor all-cause mortality. On the other hand, both medications lowered the rate of fractures.
So what should you do? Start w/your family doc who should know your medical history & family history. Then use one of several online calculators to determine your risk for breast cancer. Consider genetic testing if your risk is high eneough. And finally ask your doc about chemoprophylaxis vs prophylactic mastectomy if your genes demonstrate high enough risk.
Get out your crystal ball. An analysis of the 679 patient Gargano Mortality Study and the 936 patient Foggia Mortality Study was published earlier online this month in Diabetes Care in which the authors noted that all-cause mortality can be predicted based upon a model that includes age, body mass index, diastolic blood pressure, LDL cholesterol, triglycerides, HDL cholesterol, urine albumin:creatinine ratio, and blood pressure & insulin therapies, with validated accuracy. A web-based online version of this calculator is available. While it may be intuitive, use of this model might assist a patient or family about the appropriateness of any given procedure. Or it might provoke a patient into improving some aspect of his/her life in order to reduce all-cause mortality. Just something to ponder . . .