Making Healthy Choices™

Don Hall, DrPH, CHES
Founder and CEO of Wellsource, Inc.

• Osteoporosis Is in Epidemic Proportions

• Fruit and Vegetable Intake and Risk of Non-Hodgkin's Lymphoma

• Whole Grains and Periodontal Disease

• Vitamin K Prevents Fractures

• Health Links

• Healthy Recipes

• Resources

• What's New at Wellsource?

• About Making Healthy Choices™

Research Highlights

Osteoporosis Is in Epidemic Proportions

An editorial in the American Journal of Clinical Nutrition states that the United States has “an epidemic of osteoporosis.” Global estimates for 2006 indicate that 1 in 3 women and 1 in 10 men now aged 55 or older will have osteoporosis in their lifetime. This significantly increases the risk of serious fractures, which currently results in costs of $18 billion yearly. The editorial calls for action, “We urgently need public health strategies to maintain bone health throughout the life cycle and to prevent osteoporosis in later life.”

Also in the June 2006 issue of the American Journal of Clinical Nutrition, a research report points out the benefits of a high intake of fruits and vegetables for maintaining good bone health as well as reducing the risk for heart disease, stroke, and certain cancers (bowel, stomach, and breast). The study looked at fruit and vegetable intake in both adolescents and older persons. A positive association between fruit and vegetable intake and bone health was found in both adolescents and older women, especially stronger bones in the hip and spine, as well as higher total bone mineral content.

Based on data from this study, older women who doubled their fruit intake had a remarkable 5% increase in spine bone mineral content. Adolescent boys who doubled their fruit intake (above average) had 240 grams higher bone mineral content.

The bottom line is this. Eating more fruits and vegetables may provide a very sensible strategy for preventing osteoporosis as well as providing numerous other health advantages. The new food guide pyramid recommends eating at least 2.5 cups of vegetables daily (5 servings) and 2 cups (4 servings) of fruit daily.

Fruit and Vegetable Intake and Risk of Non-Hodgkin’s Lymphoma

Anything you can do to prevent cancer is good news. A new study by the National Cancer Institute provides good evidence that eating more fruits and vegetables may help protect us from non-Hodgkin’s Lymphoma (NHL), a common cause of cancer death.

A case control study including 466 cases and 391 controls looked at eating habits and risk of developing NHL cancer. When comparing the highest intake of certain fruits and vegetables (top 20%) to the lowest intake (bottom 20%) there were remarkable decreases in risk of non-Hodgkin’s lymphoma:

• All vegetables decreased risk by 42%

• Leafy greens decreased risk by 41%

• Cabbage family vegetables decreased risk by 38%

• Lutein and zeaxanthin (carotinoids found in brightly colored vegetables and fruits) decreased risk by 46%

• A higher zinc intake decreased risk by 42%

The authors of the research concluded, "Higher intakes of vegetables, lutein and zeaxanthin, and zinc are associated with a lower NHL risk."

Whole Grains and Periodontal Disease

Periodontal disease is a leading dental health problem and the major cause of loss of teeth. Good dental care (e.g., brushing, flossing, teeth cleaning) is important to preventing this common health problem. New research on nutrition also shows that eating whole-grain breads and cereals helps keep the gums in better health and helps prevent periodontal or gum disease.

Research included tracking dietary practices on some 34,000 men over several years. Men who ate the most whole grains (top 20% of whole-grain intake among men in the study) were 27% less likely to develop gum disease than those with a low intake of whole grains (bottom 20%). This protective effect of whole grains remained even after adjusting for age, smoking, BMI, alcohol intake, and physical activity.

If you want your teeth for a lifetime, consider eating more whole grains daily. Make the majority of your grain choices whole grains including: whole-wheat bread, oatmeal, whole-rye bread and rye crackers, brown rice, and whole-grain breakfast cereals.

Vitamin K Prevents Fractures

Maintaining healthy, strong bones is an important health goal, especially in an aging population. Vitamin K is a required cofactor for bone protein (osteocalcin) formation and is associated with higher bone density. Without vitamin K, osteocalcin lacks structural integrity thus fracturing more easily.

A new meta-analysis including 7 studies that looked at vitamin K intake shows the importance of vitamin K in preventing fracture. By pooling the number of participants in all 7 studies and their fracture rates, researchers found vitamin K to have strong protective effects for bone health.

Participants were randomly divided to receive a vitamin K supplement or a placebo. Those receiving the supplement of vitamin K showed a significant increase in bone mineral content and a dramatic decrease in fracture rates compared to those getting the placebo.

• Hip fractures dropped by 77%

• Vertebral fractures were 60% lower

• All nonvertebral fracture rates were 81% lower

Because vitamin K is a required nutrient of the body, this treatment method reported no serious adverse events as can sometimes be the case with other osteoporosis medications.

The researchers made this recommendation: Patients at risk for fractures should be encouraged to consume a diet rich in vitamin K, which is chiefly found in cabbage, cauliflower, spinach and other green leafy vegetables, cereals, and soybeans. Anyone desiring strong, healthy bones throughout their lifetime would also be wise to do the same.

Note: It is important for people taking warfarin (a blood thinner) to know that vitamin K or foods containing vitamin K may reduce the effectiveness of this medication. Ask your healthcare provider before increasing intake or for advice on maintaining proper levels of vitamin K if you are taking warfarin.

The current Adequate Intake (AI) for vitamin K is 90 mcg for women, and 120 mcg for men. However, the Women’s Health Study and the Framingham Heart Study showed that persons getting 250+ mcg/day had significantly lower rates of fractures.

Health Links

Physical Activity for Everyone

Whether you are young or old, fit or otherwise, physical activity is good for you. It can also be fun! Read this physical activity resource site from the Centers for Disease Control and Prevention to learn why - and get exercise ideas.

Carbohydrates

Whole grains are best. Read about this nutrition guideline in this article by the Harvard School of Public Health.

Nutrition Tips and Resources

Your food and physical activity choices each day affect your health - how you feel today, tomorrow, and in the future. These tips and ideas from the USDA are a starting point.

DRIs for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids

The Institute of Medicine published a summary statement on nutrition (PDF) listing acceptable ranges of intake.

Healthy Weight

Read about nutrition, exercise, monitoring, and more on this site by the Harvard School of Public Health.

Healthy Recipes

Food from the Garden

When the summer garden fruits such as tomatoes, peppers, corn, and zucchini are plentiful (plants produce them, so they're a fruit!), it may be time for a new flavor. The recipes that follow are tasty and quick. If you have time to cook a food (beans, corn) rather than open a can, the recipe will usually taste better. One website has over 60 recipes for preparing zucchini.

Basque Tomato and Pepper Salad

1 green bell pepper
1 red bell pepper
1 yellow bell pepper
3 medium or large fresh tomatoes
3 small or 1 large cucumber
1 Spanish onion

Dressing

⅓ cup lemon juice or vinegar
¾ cup extra-virgin olive oil
1 teaspoon salt
1 teaspoon sugar
¼ teaspoon dried oregano or fresh minced oregano as desired
¼ teaspoon dried sweet basil or fresh minced basic as desired
¼ teaspoon dried marjoram or fresh minced marjoram as desired
Coarsely chopped fresh parsley – for garnish

How to prepare:

1. Thinly slice peppers. Core, quarter, and thinly slice tomatoes. Thinly slice three small cucumbers or peel, seed, and thinly slice one large cucumber.

2. In a medium bowl, whisk together the lemon juice, olive oil, and seasonings. Whisk until the mixture is emulsified.

3. Pour dressing over vegetables, and toss gently with a large spoon. Cover and marinate for 1 to 2 hours, stirring occasionally. Refrigerate until serving. Garnish with chopped parsley.

Tomato and Chickpea Salad

19 ounces garbanzo beans, drained
2 tablespoons red onion, chopped
2 cloves garlic, minced
1 large or 2 small tomatoes, chopped
½ cup minced parsley
3 tablespoons lemon juice
Salt to taste

How to prepare:
Combine everything. Chill for 2 hours before serving. Taste and adjust seasoning as desired. Serve.

Mediterranean Tomato Salad

1 lb. ripe juicy tomatoes
½ clove garlic
1-2 T lemon juice or balsamic vinegar
2-3 tablespoons olive oil
Salt to taste
Minced fresh basil leaves or ½ teaspoon dry sweet basil flakes
Garlic croutons as desired

How to prepare:

• Wash and core tomatoes. Cut into slices or wedges.

• Peel garlic, and in salad bowl, puree with fork. Chop fresh basil leaves and add with salt, lemon juice or vinegar, and oil. Mix well.

• Add tomatoes and toss gently to coat.

• Add croutons as desired — they soak up the zesty juices.

Southwest Salad

1 can whole kernel corn, drained
1 can black beans, drained
1 green pepper, chopped
1 large tomato, chopped
1 purple onion, chopped

Dressing

¼ cup fresh lime juice (lemon juice can be substituted)
¼ cup olive oil
3 tablespoons chopped cilantro
1 clove garlic, mince
1 fresh jalapeno, chopped, if desired (omit seeds and membranes to decrease spiciness)
½ teaspoon chili powder (or omit and increase cumin)
½ teaspoon ground cumin

How to prepare:

1. Combine salad ingredients except tomato.

2. Add dressing ingredients to a jar. Shake well to mix. Pour over salad. Refrigerate until ready to serve.

3. Add tomato just before serving.

Resources

PowerPoint® Slides

• Preventing Osteoporosis — Shows to effect of fruits and vegetables on the prevention of osteoporosis (4 slides).

• Non-Hodgkin's Lymphoma — Reports findings from an NCI study on fruits and vegetables and non-Hodgkin's lymphoma (3 slides).

• Preventing Periodontal Disease — Lists preventive measures for periodontal disease (3 slides).

Handouts

• Stress Management — Read 12 ways to reduce stress in your life.

• Weight Management — Learn natural ways to lose weight.

What's New at Wellsource?

Wellsource adds new productivity and health cost savings report to its flagship health risk assessment, Personal Wellness Profile™

As healthcare costs continue to rise, so do the efforts of the people at Wellsource, Inc. The most recent development is a new worksite productivity and healthcare cost savings report that estimates the preventable excess costs in an organization due to rising health claims, presenteeism/ productivity losses, and absenteeism linked to health risks.

The Productivity and Economic Benefits Report, as it is named, is based on research conducted recently by the University of Michigan that confirmed a measurable link between excess costs and the number of health risk factors present in a large population of employees. Using the research findings, Wellsource developed software that projects an organization’s annual savings in the areas of health claims, productivity, and work loss days if the health risk factors of its employees are reduced.

A summary of potential savings from improvement in health claims, productivity, and absenteeism due to improved health status from a wellness program is provided, listing totals based on risk reduction goals for both the entire group and each employee. The results are presented in a 4-page graphically enhanced report.

Download a sample report

If you would like to receive more detailed information, call a Director of Business Development at 1-800-533-9355, or email well@wellsource.com.

Wellsource Inc.
15431 SE 82nd Dr.
Portland, OR 97015
(503) 656-7446

About Making Healthy Choices™

The Making Healthy Choices™ newsletter is written by Don Hall, DrPH, CHES, founder and CEO of Wellsource, Inc. with contribution from associated health professionals. It is available as a resource to Wellsource clients and other select organizations involved in promoting health.

Selected content is general health information from evidence based research. Its purpose is not to treat disease but to promote healthy lifestyles. Persons with health problems should consult their physician for specific guidance.

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