Health effects of Cola drinks

Pop, fizz, shhzzzzz.... Isn't that a familiar sound on a dry hot day when you've opened a can of your soft drink say coke, pepsi, Dr. pepper, mountain dew, 7up etc. I must admit when I was a kid these were very addictive territories and I had a bad experience drinking them. However my education while becoming a registered dietitian and common sense prevailed and then of course years later here I am writing to you this post about the health effects of cola soft drinks we are used to consuming as good as or in some cases even more than water.
Composition in a can - Most cola drinks lately have dropped the ever so flavored Kola Nut that not only was the reason why we call it cola but also it was the original flavor of the soft drinks. Now however better sophisticated flavoring agents like vanilla, cinnamon, lime, tamarind are used to differentiate between each brand of drink. The most dreaded ingredients in the drink of course are caffeine, phosphoric acid, high fructose corn syrup, aspartame/ sucralose (if diet soda), salts, citric acid, carbon dioxide (fizz).

Physiological effects - Most commonly heard, talked and written about is the one with removal of rust. Agreed that the human body physiology doesn't have any such rust problems but the key point of discussion is if what you drink can remove rust what could it do to your tender tissues inside? Steel rust removal, tooth dissolver and lavatory cleaners all are recent attributes given to Cola drinks especially coca cola. Is it really that bad? Yes, it is. How? Phosphoric acid present in the cola drinks is the prime suspect and guilty. Phosphoric acid does have a calcium depleting effect on the bones. Many a studies have been showing that the lowered bone mineral density has a lot to do with phosphoric acid as higher the phosphorus levels in the blood than calcium the bones will have to remove their calcium stored to the blood for balancing the act. Addiction to soft drinks and especially cola drinks has shown a directly proportionate relation to Osteoporosis. Caffeine content makes it possible to get addicted in the first place having anywhere from 30 -60 mg per serving (350ml) add to that the excess sugar content to worsen matters. Caffeine makes it possible to become more dependent on the drink and gives the same effects as regular coffee addicts face with heart, nervous problems and concentration. The sugar content obviously adds on to the obesity issues but even the artificial sweeteners like aspartame don't work well with the body as their metabolism down to the methyl group they come from harms the brain in the long run. Caffeine known for its diuretic qualities as much as ergogenic ones plays a vital role when the levels go down with anxiety, nervousness, a constant need to replenish more and ending up doing an overdose of cola. The acidic nature of he drink adds to the woes of the drinker for its constant lowered pH levels into the blood stream as much as the intestine and the tissues and also it is this acidic nature of colas that makes for a great cleaner of the utilities such as rusted steel, or a lavatory. The cumulutive effect could harm not only the bones but also the heart, gastrointestinal functioning, nervous system and metabolism in general affecting the hormonal function.

Food Interactions - Caffeine interferes with calcium absorption and thus mineralization of the bone leaving the bone porous aiding osteoporosis. Excess sugar also causes a lot of fat deposition in the body creating insulin resistance and therefore not allowing the body to metabolize glucose for energy generation. Many such antioxidants and minerals do not get their bio availability while combined with cola drinks. These are essential nutrients for the body as they fight and protect it from free radical attack. Phosphoric acid as mentioned above hampers the calcium as well. The flavoring artificial agents cause toxicity in the body and deplete it from the valued added nutrients it needs for regulation, immunity and repair. Even Diet Soda do no good by just a sugar content minus as the aspartame present in Diet Soda causes metabolic harm to the body as well. Sucralose is a better sweetener to aspartame but any addiction and overdose is bad no matter how good the substance.

Cola drinks are a definite no no for more than occasional especially on a regular weekly/ daily consumption. For more insights on your diet and fitness regime visit Wellness & I Programs or submit your information for a free wellness consult.

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Osteoporosis : Detection and thereafter

I have taken you through physiological, pathological and the exercise therapy side of the bone story that has been running on this blog. Today I will tell you what are the methods you should use or atleast be aware of to detect and identify any osteoporotic signs in your bones.

Now osteoporosis can cause secondary problems and it also can be caused by other diseases or disorders already existing in your body that are asymptomatic or silent. So what you should look out for are obvious signs, signs that can't otherwise be communicated by your body if it were normal. Osteoporosis is primarily detected by dual energy x ray absorptiometry (DXA) or by single energy x ray absorptiometry (SXA), although DXA is more accurate. DXA tests show T - score and Z - score, you have to keep in mind the T- score as it is the determining factor in Bone Mineral Density. The normal bone mineral density T - score is - 2.5 a standard deviation of more than or equal to 2.5 from the normal is considered to be red signal for osteoporosis. DXA test is like the final frontier of sorts in the detection process as it clearly showcases the structure of the bone and its density. Before we arrive at DXA there are certain serological tests that need to be run to zero down on bone mineral density (BMD)test. The blood test that is essential is serum calcium, serum alkaline phosphatase (Alk Phos), serum parathyroid hormone (PTH), Vitamin D, thyroid profile and for women above the age of 45 years Follicle Stimulating Hormone (FSH), Leutinising Hormone (LH) to check for onset of menopausal symptoms. The relevance of these tests are as follows :

1. Serum calcium - As I have explained in my previous posts that the reason for loss of bone density is the loss of bone calcium into the blood. Therefore serum calcium levels can be a good indicator for BMD. Normal levels of serum calcium are 8.5 - 10.5 mg/ dL. Elevated serum calcium show hyperparathyroidism or malignancy and decreased levels of calcium show malnutrition and osteomalacia. Hyperparathyroidism as we know is due to the reactivity of the lack of calcium in the blood and imbalance in the remodelling and modelling of the bone. However if the levels show decline in calcium it means that there isn't enough calcium in the body to be mineralised in the bone and hence high PTH would again try to remove calcium from bones to level blood calcium. Malnutrition is the major reason for a drop in blood calcium levels. Malnutrition could be lack of dietary calcium or Vitamin D or due to asymptomatic intestinal disease like celiac sprue, chronic intestinal irritability,intestinal cancer etc.

2. Serum Vit D - Vit D as we all know by now is a factor important in the absorption of calcium in the gut but also for its mineralization in the bones. Serum Vit D of > 32 ng / ml is considered normal. Vit D levels need to be adjusted by supplementation through oral vials or injection.

3. Serum PTH - Parathyroid hormone is the most crucial factor to determine the onset of osteoporotic activity in the bones. The serum elevated levels of PTH signify the loss of bone mineral density and aggrevation of remodelling sites in the bones cells, also the elevation of calcium in the blood and alkaline phosphatase. Normal levels of serum ALP is 20 - 140 IU/ L. Bone alkaline phosphatase levels elevate as it is a byproduct of the bone activity. Imbalance in the ratio of remodelling to modelling sites can lead to elevation of ALP levels. PTH levels when found declined can mean malignancy (cancerous) of the bone. Further biopsy will be required to indentify malignancy. PTH levels can also be elevated if TSH levels are imbalanced therefore a proper TSH, T3, T4 levels of the thyroid activity should be checked.

4. FSH and LH - In women who are in their perimenopausal stage around the age of 45 - 50 years and in given recent scenario even lesser age group have lower estrogen levels in their blood which only means their stimulating hormones will have elevated levels in the blood. Lower estrogen only means that there is certainly going to be imbalance in the bone mineral ratio, PTH will be elevated as estrogen brings about more bone reodelling sites and could also navigate into the inner (trabeculae) bone cells to weaken the structure.
Now you know your tests and you know what the test results translate into, but be sure to know that detecting osteoporosis can also mean detecting an underlying disorder which has been laying there silent all this while. Most of the times treating the primary cause of osteoporosis takes care of the bone disorder itself. Be sure of any such disorder priotise to treat it first and follow the therapy I have earlier explained for osteoporosis.
I will soon be writing on the diet therapy for osteoporosis and busting many myths too. So keep reading and see you here soon.

Wish you wellness,
Neha Wasnik
R.D
Related articles - http://wellnessandi.blogspot.com/2009/08/osteoporosis-metabolic-cause-and.html
http://wellnessandi.blogspot.com/2009/09/exercise-for-osteoporosis.html

Exercise for Osteoporosis

I mentioned about the the physical therapy for osteoporosis includes weight bearing exercises in my previous post. Now you obviously want to know which exercise is weight bearing and which isn't, this post will speak all about it.

Weight bearing exercise literally means the activity that puts your bones to bear your body weight. Although our bones always bear it the activity induces positive stress which helps the bone mineralisation and lowers bone loss. I will also enlist the kind of exercise you should stay far away from if you have low bone density.

Weight Bearing Exercises for Osteoporsis prevention and cure:
1. Strength Training - If you have read this blog from the begining you must have noticed my emphasis on strength training exercise. I am pro strength training not because it gives you a chiseled look but because metabolically you couldn't have asked for a better gift. Strength training exercises that bear weight are low - medium intensity squats (with or without add on weights), same goes for lunges however please make sure you are accompanied by a trainer inorder to correct your form during the exercise as squats and lunges if done in incorrect posture can do you harm than good. Leg extension and hamstring curl are another form of strength training exercise that allow weight bearing also good for building strength in the muscles around your knee and why is that so good for osteoporosis? Well matter of factly the knees bear the weight partially of the lower body next to the lower spine, so if your knees are strong they can afford to bear weight better. Hyperextension of the back can also be good for the spinal bones strengthing the back muscles too, wrist flexion is also a good strength training exercise. The focus of these exercises I just mentioned is to firstly impact your hip, femur, tibia, wrist bones and spinal bones where osteoporosis is majorly seen. Strength training can also be done without any add on weights and that is what I personally practise too. You can do all the above exercises with the help of your own body weight with a little more intensity added to it. The use of terra bands, tubes, physio ball, water workouts for these exercises has turned out extremely beneficial. My mother started out with weights and then slowly moved towards resistance tube and it has shown remarkable impact on her osteopenia.

Cardio exercises - Walking is the best of all the options and it is absolutely possible wherever in the world you are with a good pair of shoes of course. Walking puts adequate weight on the bones to impact on the reduction of bone loss. Similarly medium intensity elliptical trainer is also good as is climbing the stairwell to your apartment instead of the elevator. Infact climbing stairwell has proved to be a very good alternative in times when you cannot go out for a walk but need to continue exercising just keep your posture erect. Like wise swimming and water aerobics have benefits however these are more helpfull during immediate rehabilitation after a fracture secondary to osteoporosis.

Yoga - The good old yoga proves to be a good weight bearing alternative but there are some asanas where you bend forward your turn your spine which would go against the idea of preventing osteoporosis, so don't attempt those positions.

Stretching - Sometime back I had given 9 stretching exercises to attain flexibility well it also is beneficial for osteoporosis. What you need to lower bone loss is have good weight impact on your spine and lower body bones with an erect posture. Joints where osteoporosis is frequent are hip, wrist, spine and if these are not flexible enough or lets just say are stiff your core muscles (abdominal and lower back) will pull you forward giving a hunch back look and thats no good news for your spine bones which are already under stress of low bone mineral density and compression fractures. Stretching will free the joints and help attain a good posture and balance to the body keeping the add on stress on these bones at bay.

DO NOT ATTEMPT THESE EXERCISES FOR OSTEOPOROSIS :
These are red alerts as far as osteoporosis is concerned, running, jogging, skipping, bowling, playing sport that bends your spine diagonally or impacts directly on knees and lower back. Why and How are your immdiate questions so lets answer them one at a time.

Why? - Visualise the running or jogging activity in slow motion and concentrate on the leg movements. Do you see when the foot hits the ground the weight shifts first on the knee and then on the lower back with high impact? Well that is not what we want to achieve the high impact.
How ? - We do not want these impacts because they cause compression of the spine bones, knee joint and hip joint. Compression of the bones is what will speed the fractures rather than avoid them. So do not attempt these.

Wish you wellness,
Neha
R.D
Related articles - http://wellnessandi.blogspot.com/2009/09/osteoporosis-benefits-of-physical.html
http://wellnessandi.blogspot.com/2009/08/osteoporosis-metabolic-cause-and.html

Osteoporosis: Benefits of Physical Therapy

After we have seen all the pathophysiological evidence as to how osteoporosis begins and develops we arrive at a point to discover what are the options we have, to reverse it. Well honestly reversal or not depends how bad the situation is. If the bone is depleted completely its difficult physically for the person to do except therapy and of course nutrition and hormonal therapy. How does physical therapy help?
Medical researches all over the world across genetic pools, age, gender have given significant evidence of weight bearing exercises reducing bone resorption or bone remodelling. The major problem we face in osteoporosis is as we now know the continuous battle between bone mineral deposition and its removal to balance the calcium in the blood. Exercise that bear our weight or any tolerant weight with correct posture and body form helps tremendously in reversing the bone resorption effects. Its no wonder that when NASA sends astronauts to zero gravity they face a challenge to maintain bone mineral density if exposed to weightlessness for a long period of time continuously. No amount of good nutrition, hormonal balance is good enough if the proper exercise or physical stimulus to the bone isn't available to develop it.
I know you want to know how does gravity or bearing your own weight help osteoporosis when obesity can also threaten it? Well, remember that a child in his/ her growing years shoots up like an unkept lawn grass before you even realise it, just like grandma always says to grow up you must go out and play. The primary reason bones develop on a stimulus of the growth hormone in childhood is because it is complemented by physical stimulus to the bone cells to deposit more calcium to develop it inorder to sustain the physical demand on it. Unless there is a demand in the body there will never be a supply and that's a GIVEN. So the body or lets say the bone cells respond to the stimulus (hormonal and physical) of exercise that puts a demand over bearing weight. The stimulus is a message to our body for strength demand so the bones quickly respond in slowing the resorption or remodelling of the bones and work towards bone mineral deposition or modelling. If you ask a simple question as how on earth would the bones know if they need to grow or not ? the answer would be as simple as the baby that cries gets his milk. Our body would cry for strength and therby our bones would fulfill it. Now this fulfillment of bone modelling on a stimulus upon exercise can be met if the nutrition is fine otherwise the body ends up in a viscious cycle of malnourishment.
What are the actual benefits of weight bearing exercises on osteoporosis other than a mere stimulus you may ask? well it builds good strength in the musculation which enhances the overall strength of our body and also our agility and body posture and that is what we need ultimately to avoid a trip and fall fracture.
In my next post I will write on the various exercise you can do that will send your bones the stimulus to slow your bone remodelling.

Wish you wellness,
Neha
R.D
Related articles -
http://wellnessandi.blogspot.com/2009/08/osteoporosis-from-where-does-this.html
http://wellnessandi.blogspot.com/2009/08/osteoporosis-metabolic-cause-and.html

OSTEOPOROSIS - From where does this silent killer creep in?

First of all I apologise for this long over due sabatical from the blog. I was working on bringing you something very close to my heart and I have now compiled a series of article topics which will be including my friend's request to write on menstrual body pain and also about fitness for sit at home people who just don't want to go to the gym.
So about this series of blog articles I am going to write everyday will be on Women's Health (of all ages). Before al my male readers turn away let me tell you some of the things I unravel to you is applicable to today's man too. If you are close to any female kind and I hardly doubt if you're not then this series is for you.
Osteoporosis has long been considered as a bone disorder of the elderly. Frankly not everyone knows what it factually is. All they can tell you is something to do with the bone and perhaps as far as a fracture in women. Well people guess what times have changed and we are solely responsible for it. In 2005 my mother was experiencing excruciating pain in one of her hip joint, she just neglected for a while thinking it was fatigue. It got to a point where she couldn't sit down or bend to pick things up from the floor. Needless to say she almost faced immobility, as I clearly recall that day when I came home from my health club to find my Mom struggling to get up from the bed. She then (somehow) got an MRI, Bone Density test, Serum calcium, Vit D, hormonal tests done. We found she wasn't osteoporotic, yet. She was osteopenic, which only meant that it will be sometime soon when she would be categorically under OSTEOPOROTIC status. That day when she found out she knew what I meant when I told her deliberatly deafened ears to start working out and stop comfort food as an excuse to feeling exhausted. In one year's time she not only lost 30 Lbs of dead weight but reversed her bone deterioration, of course with diet and apt exercise module along with Vit D supplementation. You have to really coax her today to give up one day of workout. So the question still remains what is it that we do to end up being susceptible to osteoporosis and that apart why do medical sciences tag it a 'SILENT KILLER'? I can understand your dilemma coupled with curiosity, but osteoporosis does more harm to our body than just bone frailty. This is what I will write about in this series.
To understand the pathophysiology (its effects) of osteoporosis we need to understand what is our bone structure made of. Simply it is nothing but a meshwork of protein molecules which have mineral fixations into it making it look like a wholesome sturdy structure. Protein forms the major support for the actual bone, while minerals like calcium, phosphorous, give it its sturdy tough body. Without the adequate mineral deposition in the protein meshwork the bone is just a croche of protein with big holes in it. Remember how you grow taller upto certain age and then just stop growing no matter how tall you want to be? Thats called growth of the epiphysis simply explained when we're young as in really small babies our bones aren't completely formed to what they are now. There are spaces between the firm bone structure that awaits development so we grow taller into adulthood. This process takes place along with the growth hormone by constant mineral deposition in the protein structure of the bone. At some point the growth hormone release is inhibited and the bone growth eventually stops. Our bones go through a process called as absorption and this continues upto the age of 35. After 35 however bones go through a turnover process i.e. absorption and resorption. The bone turnover determines the actual net bone density, which only translates into whether your bone is absorbing more calcium or giving away more calcium. This turnover is initiated by the overall process called ageing. Secondary to natural stimulus for bone resorption are factors that accelerate bone calcium resorption like obesity (too much weight on the ones), calcium defeciency(not enough calcium in the blood), Vit D defeciency, thyroid hormone abnormality, malnutrition overall, oestrogen imbalance. if you manage to do all the above mentioned activities you'll be succesfull in depleting your bones from calcium thus inviting with warm arms a permanent guest called OSTEOPOROSIS to your humble body. What osteoporosis will do after it starts developing is frailty in your physical self. Frailty leads to accidents, or immobilisation like in the case of my mom. Frailty of the bones also means your nervous plexi which were protected by adequate bone space is now facing muscular pressure as the body structure is weak and cannot hold major muscles in their original way. If the nerves are pressed there is neural damage symptomatic as dysfuntional part of the body the nerves are supplying brain impulses to. Now you can multiply all this into why this silent unwanted guest is a killer, a silent killer. Watch out for more on this topic as I unravel more about Osteoporosis and general health.