Omega-3s dominate discussions; renowned Harvard researcher calls vitamin D, not calcium, key to bone health
by Randy Hartnell and Craig Weatherby
Last week, we attended Dr. Andrew Weil's 3rd annual Nutrition & Health conference, which we were also proud to co-sponsor. As before, it included a one-day public session, followed by a three-day continuing education course for physicians and other health professionals, held this time amid the canyons of midtown Manhattan.
Dr. Weil's purpose is to inspire doctors to help deflect the gathering perfect storm of public health consequences brought on by Americans' sedentary lives and grossly imperfect diets. And his personal message had to do with a familiar theme: the role of inflammatory, omega-3-poor diets in promoting our most common diseases.
To view Dr. Weil's conference Mission Statement, see “Desert Conference Yields New Diet Consensus”, our report on his first Nutrition & Health gathering.
A stellar roster of distinguished researchers presented the latest findings on nutrition, and explored their practical applications for the attentive audience of physicians, dieticians, and other health professionals, who received academic credit from Columbia University's College of Physicians & Surgeons.
Many of the talks focused on the health value of specific foods, such as herbs, fish, tea, soy, milk, and mushrooms, but it seemed to our admittedly biased eyes and ears that the biggest buzz surrounded omega-3s.
Indeed, fish fats vied with whole soy foods—and, if considered collectively, antioxidants from tea, berries, and dark chocolate—as subjects of the most lecture time and audience interest, thanks no doubt to the steady stream of highly encouraging findings on omega-3s and health reported in recent years.
We have to admit that the crowd's friendly attitude toward omega-3s and fish may have been enhanced by the healthy portions of Vital Choice lox, sablefish, and salmon sausage served at breakfast and lunch. If so, we plead guilty. If not, we blame the kitchen, which time and again seemed prone to err on the side of over-cooked.
While the oil-rich rich sablefish tolerated the abuse reasonably well, our new sockeye salmon sausage patties emerged from too long in the warming pans resembling something closer to a small disc typically batted around on ice than the culinary treasure we had eagerly anticipated. (By the way, we now expect that our new salmon sausage—complete with cooking instructions—will be available on our website sometime in June.)
Speakers address broad themes and burning topics
In her introductory address, famed nutrition educator and author Marion Nestle, Ph.D. of New York University presented a series of amusing but depressing slides that documented the state of American diets and health.
Many of us guffawed, but then had to groan, at slides showing dozens of packages of junky children's foods, all bearing a beaming Sponge Bob Squarepants and blaring fully legal but highly misleading claims of health or nutritional merit. Say it ain't so, Bob.
Dr. Nestle ended her inspiring address with six common-sense tips for shopping and eating:
Her stage-setting talk was followed closely by the entertaining, enlightening tag team of Richard Decklebaum, M.D. and Joseph Hibbeln, M.D., who focused on omega-3s for physical and mental health.
They showed, persuasively, that the preponderance of evidence confirms the heart, brain, and broader health benefits of raising omega-3 intake with fish and supplements, and reducing omega-6 intake, by cutting way back on foods made with seed oils (soy, corn, cottonseed, sunflower, sesame, and canola).
Some of their most startling slides displayed the enormous increase in Americans' consumption of omega-6-rich soy and corn oils (and decline in omega-3 intake) over the past 50 years and parallel increases in degenerative conditions like cardiovascular disease, diabetes, depression, anxiety, and allergies, all of which are linked to imbalances in intake of omega-6 (inflammatory) and omega-3 (anti-inflammatory) fats.
Perhaps the most broadly relevant research and significant, novel details emerged during eight of the many enlightening presentations:
The basic message we heard all week was that doctors need to educate themselves on these links between diet and disease, better inform their patients, and enter the political fray on all our behalves.
Perhaps the greatest myth-smashing presentation was made by one of America's leading nutrition lights, Walter Willett, M.D., the nutrition chair at Harvard's School of Public Health.
Harvard's expert rejects calcium's exaggerated reputation
Walter Willett, M.D. spoke on the last day, and his presentation was one of the best-received, probably because it clarified the facts regarding one of the chief conundrums facing physicians and patients: is calcium really the key to bone health?
When the mass culture is dominated by “Got Milk?” ads and knee jerk acceptance of calcium as key to bone health, it may seem heresy to suggest otherwise, but insiders like Dr. Willett know that the calcium emperor has few if any clothes.
In fact, the countries with the lowest rate of fractures tend to have the lowest calcium intakes, and vice versa. Dairy-loving lands tend to suffer the highest rates of osteoporosis and fracture, while people who eat east-Asian and other low-calcium diets enjoy the lowest risk. Got milk? No, thanks.
Thus, it appears that beyond a minimum requirement in the range of 250-400 mg per day, more calcium is not much of a help to bone strength. This is unsurprising, since the process of bone-building relies on many other factors, primarily vitamin D, which is critical to the body's ability to use—you guessed it—calcium. Absent adequate vitamin D—whether from sun, foods, or supplements—there's little evidence that extra calcium does any good, while we know that it does raise the risk of kidney stones.
Professor Willett teaches and directs research projects at the Harvard School of Public Health, and over the past 20 years, he has emerged as one of the most respected nutrition authorities in the world. (We recommend his consumer-oriented book, Eat Drink and Be Healthy very highly.)
We thought it significant that he chose to spend his time exploring widely held beliefs about calcium and bone health. Dr. Willett's lecture—titled “Three Servings of Dairy Per Day: Essential Nutrition or Udderly Ridiculous?—highlighted the wide gap between perception and reality.
Slide after slide demonstrated a clear lack of evidence in favor of calcium, and the failure of science to find a consistent correlation between higher calcium intake and lower fracture risk. In fact, as he demonstrated, none of the major studies conducted to date shows any benefit from taking high-dose calcium supplements.
For example, a recent analysis of data collected by the Women's Health Initiative (WHI) project failed to show much benefit, and it appears likely that much of it stemmed from the vitamin D the women were taking (See “Women's Bone-Health Study Yields Fractured Results”).
As Dr. Willett said, neither the WHI study nor any of the other relevant clinical trials conducted to date demonstrate a clear benefit from taking the recommended amount of supplemental calcium (1,000 mg per day for men and women aged 19-50 and older; 1,200 mg per day for men and women aged 51 or older).
While calcium does appear to protect against colon cancer, the drop in risk ceases after consumption reaches about 800 mg per day. And, some research suggests that intake of calcium above that level may increase the risk of prostate cancer.
Vitamin D enjoys better evidence of dose-dependent benefit
In stark contrast, Dr. Willett showed slide after slide documenting the evidence that the risk of bone fracture falls as intake of vitamin D intake rises. And as our readers know, recent research suggests that this often-overlooked nutrient may exert uniquely powerful protection against cancers of the breast, prostate, and colon (see “Vitamin D May Diminish Breast Cancer Risk Drastically” and “Higher Vitamin D Intake Could Cut Cancer Risk in Half”).
While Dr. Willett acknowledged the obvious fact that modest amounts of calcium are essential to overall health, he emphasized that the evidence does not support the conventional wisdom that very high current RDAs are necessary for bone health or colon-cancer prevention.