If you want to build strong, flexible bones, calcium isn't the only nutrient you need to take. Contrary to what you hear in the mainstream press, too much calcium makes your bones brittle. In fact, I've stressed the importance of increasing magnesium and not taking too much calcium for 20 years.

I've also talked about the importance of getting enough vitamin D, the sunshine vitamin, and doing regular bone-stressing exercises. There's no doubt about it. You can't make healthy bones without all of these. But they're not enough.

For maximum support, there's a little-known trace element that can double or even triple your bone density!

Increase your bone density by 14%

This mineral appears to be one of the most effective substances found yet for preventing and treating osteoporosis. Because of its chemical similarity to calcium, it can replace lost calcium in your bones and teeth, increasing bone density. Plus, it appears to draw extra calcium into your bones, making them thicker and stronger.

Multiple studies show this mineral is critical to helping you build "bones of steel" that make you resistant to life-threatening fractures. One three-year study published in the New England Journal of Medicine involved 1,649 postmenopausal women diagnosed with osteoporosis.

Women who took this mineral, along with calcium and vitamin D, cut their risk of fracture by 49% in the first year of treatment — that's nearly in half! Plus, they increased the bone density in their backs by 14.4% and in their necks by 8.3% on average. By contrast, those who took only calcium and vitamin D saw no increase in bone density.

So what is this remarkable bone builder? It's strontium, a naturally occurring element found in soil and water. The amount of strontium found in our diets is probably between two to four mg a day, depending on how much gets into fruits and vegetables from the soil and water, and how much is in our drinking water. Strontium makes bones stronger and denser when taken in larger doses.

Calcium and strontium are almost identical in their ability to accumulate to bone. Together, they increase bone density more than calcium alone. The amount of strontium that will protect you is unclear. Studies suggest it takes 300-600 mg a day, while others say a minimum of one gram. We need additional studies to know just how much strontium it takes to protect the bones of older women who already have osteoporosis. But since it appears to be non-toxic, you may want to give it a one-year trial.

Most studies on strontium have used a synthetic form called strontium ranelate. The reason for this is simple: Strontium ranelate is a drug patented by Servier Pharmaceuticals. Pharmaceutical companies can afford to pay for expensive trials, and the research on strontium ranelate is compelling.

But strontium ranelate isn't the only form of strontium that builds bone. It may only be the most expensive form. An older study used strontium lactate to treat osteoporosis at the Mayo Clinic. In this study, scientists gave 1.7 grams of strontium lactate three times a day, one hour before meals. They found that 84% of the patients in this study had marked improvement. Strontium gluconate and strontium carbonate also have been used to successfully remineralize bone.

There are enough studies on strontium's safety and effectiveness in bone health for me to suggest you consider it. Strontium is completely nontoxic, even when administered in large doses for prolonged periods. In fact, it's been safely used as a medicinal substance on humans for more than 100 years.

What's more, a two-year, double-blind study found strontium to be safer than a placebo! Not only did the women taking strontium significantly increase their bone mineral density, they experienced fewer side effects than those taking the placebo.

How much should you take?

In the study showing a significant increase in bone density for healthy, younger postmenopausal women, there was only a 2.4% increased benefit after taking one gram of strontium ranelate for two years. On the other hand, another study found that just 680 MILLIGRAMS (roughly two-thirds of a gram) of strontium reduced the risk of a vertebral fracture by 41%. This is impressive.

If you're at high risk for osteoporosis, strontium may be just the ticket. With no toxicity reported, it's at least worth talking over with your doctor. I would certainly take 450-650 mg of strontium daily before considering Fosamax or other pharmaceuticals, which have unwanted side effects. I also recommend you focus your osteoporosis treatment on magnesium and strontium rather than overdo calcium or take supplemental vitamin K. The latter are important for your bones, but you don't want to take too much of them.

Strontium citrate, strontium lactate, and strontium gluconate can be found in some supplements in health food stores. Advanced Orthomolecular Research (AOR), a Canadian company, offers 60 capsules (two daily) of Strontium Support with 227 mg of strontium citrate for $20 (www.AOR.ca, 800-387-0177). Citrates are notoriously well-absorbed carriers. This is the form I would use. By the way, I have no association with this company.

Vitamin K and osteoporosis," Arbor Clinical Nutrition Updates, March 2005.

Ryan-Harshman M. and W. Aldoori. "Bone health. New role for vitamin K?" Can Fam Physician, July 2004.

Gaby, Alan R., MD. Preventing and Reversing Osteoporosis, Prima Publishing, 1994.

Meunier, P.J., et al. "The effects of strontium ranelate on the risk of vertebral fracture in women with postmenopausal osteoporosis," N Eng J Med, 2004:350.

McCaslin, F.E. Jr. and J.M. Janes. "The effect of strontium lactate in the treatment of osteoporosis," Proc Staff Meetings Mayo Clinic, 1959;34(13).

Shorr, E. and A.C. Carter. "The usefulness of strontium as an adjuvant to calcium in the remineralization of the skeleton in man," Bull Hosp Joint Dis, April 1952.

Nielsen, S. Pors. "The biological role of strontium," Bone, July 15, 2004.

Reginster, J.Y., et al. "Prevention of early postmenopausal bone loss by strontium ranelate: the randomized, two-year, double-masked, dose-ranging, placebo-controlled PREVOS trial," Osteoporos Int, December 2002.

How Safe is Vitamin K?

Vitamin K isn't a single vitamin, but a group of fat-soluble compounds found primarily in dark-green, leafy vegetables. It's also made in our intestines by friendly bacteria. Since antibiotics destroy these bacteria as well as harmful ones, it's important to take good probiotic (friendly bacteria) supplements after you use antibiotics or suffer from a bout of diarrhea.

Vitamin K has several important attributes. When it comes to bones, it attracts calcium. In fact, vitamin K helps build bones by getting calcium into them. It also prevents bone from breaking down by helping to keep it there.

The aging factor

As we get older, we tend to eat less foods high in vitamin K. Let's face it. Few people eat even one good serving of green, leafy vegetables every single day. In addition to insufficient dietary vitamin K, cholesterol-lowering drugs, fat-free salad dressings, and poor digestion can prevent it from being absorbed. This explains why women with osteoporosis have been found to have low levels of vitamin K.

You need some vitamin K for strong bones, but experts disagree as to how much. Since many supplement companies have bone-support formulas with vitamin K, it's easy to think that taking higher amounts is safe. But I think that vitamin K supplements have the potential to be harmful. Let me explain why.

Its attraction to calcium helps vitamin K form strong bones. But its clotting properties make vitamin K a "no no" for anyone who is taking blood thinners, such as Coumadin (warfarin). Everyone on blood thinners knows this. Even if you're not taking blood-thinning medications, you're probably getting additional vitamin E, gingko, garlic, or other nutrients in your supplements that thin your blood.

It's vitamin K's clotting factor that worries me. We know that heart disease and stroke are major health risks for postmenopausal women. That's why so many people take natural blood thinners in the first place! Do you really want to take a supplement that has the opposite effect and can contribute to blood clots? I don't. Especially not when there are other, safer options. The jury's still out on the safety of high amounts of vitamin K. Doctors I've spoken to are worried.

A National Institutes of Health study at Tufts University is currently examining the role vitamin K plays in bone development in the elderly. I'll be looking at it closely to see whether or not researchers find an increase in blood clots. I don't question whether or not vitamin K works to support healthy bones. Researchers are just not sure about how much you should take.

For now, I suggest keeping your intake of vitamin K relatively low. If it's in your multivitamin or bone formula, that should be plenty (preferably 99 mcg or less). I wouldn't add any additional vitamin K supplements to your regimen.

Haas, Elson M., MD. The New Detox Diet, Celestial Arts, 2004.

The Invisible Substances That Destroy Your Health (And How to Avoid Them)

Last month, I talked about a deep detoxifycation program that can help rid your body of difficult-to-eliminate toxins. This is especially important if you've been exposed to harmful chemicals, or if you have a serious illness. But there are many levels of detoxification, and all of them are beneficial. If you're not ready to go on a deep-cleansing program or fast, perhaps an easier and gentler program will fit you better.

The ideal time for a deep cleansing is in the spring, when everything in nature is being rejuvenated. Or any time your health is at risk. But the best time to reduce your intake of toxins is right now. Seemingly minor steps can have a profound effect on your present and future health.

So for the next month or two, I'd like to suggest you reduce your exposure to as many harmful chemicals as you can. By doing so, you may find you have fewer colds and flu when winter hits.

Begin by reducing your exposure to pesticides. The biggest problem with pesticides is that you can't see or taste them. It's difficult to comprehend that a box of commercially grown strawberries is laced with harmful pesticides, but it is. A few heavily sprayed strawberries may not hurt you. But add them to the pesticides on all of the foods you eat, and you've added heavily to your body's toxic burden. You may never know what effect the accumulation of pesticides will have on your health. Some illnesses are never traced back to them, but many chronic health problems improve after detoxification. We do know that some cases of Parkinson's disease can be traced to a high exposure to pesticides.

This is the perfect time of year to switch over to organic fruits and vegetables when they're most plentiful and least expensive. But don't limit your organic foods just to produce. Coffee and chocolate are sprayed heavily with pesticides unless they're organic. If you're a coffee drinker, buy organic coffee. And pick up some organic chocolate at your local health food store for an occasional treat.

Reduce alcohol, refined sugar, and caffeine. I didn't say eliminate them. Just have less. This allows your body to eliminate other toxins you've been holding onto more easily.

Too much alcohol, sugar, or caffeine increases inflammation and can rob your body of important nutrients. I'm not against anyone having a cup of (organic) coffee a day. Or eating an occasional dessert made with refined sugar. It's the excess that's harmful.

Clean up your cleaning. Commercial cleansers and pest control products are expensive and laced with chemicals that are harmful to our bodies, our pets, and the environment. Just read their labels. If they say, "danger," "warning," "caution," or "fatal if swallowed," they contain ingredients to avoid. For a list of these harmful ingredients, I'd like to suggest you get Annie Berthold-Bond's book, Clean & Green: The complete guide to nontoxic and environmentally safe housekeeping (Ceres Press, 1994). Not only will it explain which chemicals to avoid, it contains hundreds of simple low-cost formulas you can make to clean everything from ovens to shower nozzles, air fresheners, and metal cleaners. Annie also lists companies that make non-toxic products you can find in health food stores and many supermarkets.

A number of companies have come out with excellent chemical-free products. I particularly like several products made by Bi-O-Kleen. They include citrus seed and citrus peel extracts that disinfect and deodorize. I gave some to a professional house cleaner I know to try out. She found they worked better than any other products she had used.

Go through all of your cleaning products and read their labels carefully. Get rid of any that contain toxic ingredients. But don't just put them in the trash. They're harmful enough to the environment that you need to take them to a toxic clean-up site in your community. Call your local garbage pick-up company to find out how to safely discard them. Anything this toxic to the environment shouldn't be used in your home or garden!

Increase your water and fiber. I've said it before. Your body will naturally eliminate some toxins through solid and liquid wastes if you eat enough fiber and drink enough water. Half a glass of pure, filtered water every hour helps flush them out. Otherwise, they can be re-absorbed and become even more harmful.

Cellulose (from plant foods) and other forms of indigestible fiber (like wheat bran), act like sandpaper in your intestines. They're the little scrub brushes that keep bad bacteria from adhering to intestinal walls and contributing to low immunity, poor nutrient absorption, and such health problems as Candida albicans and colon cancer. During the time you decrease your intake of toxins, be sure to have at least two to four good servings of high-fiber foods every day.

It doesn't take much. But making these simple changes can have a dramatic effect on your health.

How a Mouse Can Give You a Fabulous Massage (And Other New Products & Trends)

Every year, I attend a huge four-day convention for health food store buyers. The event helps me stay up on the latest trends in the market. Trends drive marketing campaigns, and the products featured at this year's trade show are the ones you're going to hear the most about in the coming months.

Last year, the trend was "low carb" everything. I warned you not to fall for these products because the issue is the quality of carbohydrates (unrefined vs. refined), not just the amount. This year, there was a huge drop in low-carb foods. Instead, the emphasis was on antioxidants. Antioxidants in supplements, foods, and drinks. Once again, this trend comes with a warning.

Don't get me wrong. Antioxidants are great. They protect us against the harmful effects of destructive molecules called free radicals. By doing so, they guard against heart disease, cancer, and many other chronic degenerative diseases. But too much of a good thing can have negative effects. Very high amounts of antioxidants can actually suppress your immune system, as I told you in November 2003. Please re-read this important article (which is available on my website) before investing a lot of money in antioxidant supplements.

When it comes to antioxidants, your body's ability to activate and use them is key. Not just the amount of one or two antioxidants. You need the necessary co-factors to use them, and you need a balance of antioxidants. Be wary of the antioxidant-rich fruit drinks and supplements that will be coming on the market. They are usually high in one or two antioxidants rather than a balance of many.

Antioxidants are found in fruits and vegetables and we should
all eat good amounts of them every day. There's an easy way to know whether or not you're getting a balance of antioxidants. Just eat foods with a variety of colors. Each color represents a different antioxidant.

Best of show

Another reason I attend this trade show is to tell you about several products out of the thousands I see that I don't want you to miss. Some come from small companies with few advertising dollars. If I didn't write about them, you might miss them entirely. Others are products you can find on store shelves, but without trying them first, you might not know whether or not they're effective. Here are my favorite products from this year's show.

Nature's Tears EyeMist: I wear contact lenses and work on a computer a lot, so my eyes get dry at times. All of us tend to get dry eyes as we age, whether or not we wear contacts. Eye drops are not always the answer, especially when you're driving. And they can wash out some of the nutrients on your eyes. Besides, they tend to run down your face and get messy. That's why I like this little spray can of preservative-free pure water. Just hold the can 8-10 inches away from your eyes, keep them open, and spray. A gentle mist re-hydrates your eyes and moisturizes your face.

You can find Nature's Tears EyeMist in most major pharmacies. A single can costs around $7.95, while a double package is usually $14.95. Is it worth paying a bit more for an eye spray? It is for me.

Dr. Tung's Smart Floss: You might wonder why I'm excited about dental floss, but anything that removes additional plaque from teeth gets my attention. Bacteria in the mouth can lead to periodontal disease and can contribute to heart problems. This particular dental floss removes up to 40 percent more plaque than other flosses. That's impressive! Just cut off a length of floss, stretch it a little, and suddenly it becomes a wider floss that grips more plaque as you use it. Because it's soft, Smart Floss doesn't irritate your gums.

Smart Floss is packaged in three bright colored, round containers. If you can't find it in your local drugstore, you can order three packets for just $9.45 through the Internet (www.toothandgum.com) or by calling the company direct (800-222-0935).

Drainbo: If you live out in the country like I do, or if you don't want to use caustic chemical drain cleaners that harm the environment, you'll want to keep a bottle of this drain cleaner on hand. It contains seven strains of bacteria that eat up the grease and protein wastes that clog your drains. Hair and residues of soaps and detergents get eaten up like PacMen, and the bacteria in Drainbo won't harm septic systems.

This product isn't widely available, but you can order it from the company either through the website (www.drainbo.com) or by calling 877-DRAINBO. The smallest size is a half-gallon container that sells for $19.99 plus shipping — enough for you and a neighbor to have on hand whenever a drain becomes clogged.

Massage Mouse: Okay, I confess. This is my favorite product from this year's health industry trade show. I've seen and tried massagers before, but none like this one! The Massage Mouse is a "hands-free" device that looks a little like a computer mouse with two wires that end in little sticky pads. You moisten the pads with water and place them on your body — like on your tense shoulders, for instance. Turn this battery-operated device on, and you get a massage that feels like a person is giving it. Since you don't have to hold the massager, you can relax while you let it work.

Most massagers have one buzzing sensation in two strengths — low and high. This one has a variety of random sensations: buzzing, tapping, and a sensation that feels like someone is actually massaging you. You can actually see and feel your shoulders move up and down when the Massage Mouse is in this mode. I like the feature that allows you to move the intensity from very low to very high. And the fact that it turns itself off after an hour. This means that if you use it in bed to help your muscles relax, it shuts off if you fall asleep.

If you ever wished you could get a massage when your muscles were tight, now you can afford one at any time. The Massage Mouse is available for $68 from Hi-Dow (www.hi-dow.com, 314-205-1689). For the price of one massage, you'll be able to get relief from your sore muscles forever.

Nutrition Detective

Diabetes Affects Your Mind

If you have diabetes, it can greatly decrease your brain function. That's what researchers found when they compared women with type 2- diabetes to those who didn't have diabetes. According to the study, the women who were not on anti-diabetic medications had poorer brain function than women without diabetes or women on medications. The two-year study tested nearly 19,000 former nurses aged 70-81 for memory, verbal fluency, and counting numbers. The results were startling.

Diabetic women had 25-35% greater odds of a poor score than women without diabetes. And the longer they had diabetes, the worse their memory. Women with diabetes for 15 years had a whopping 50% chance of decreased brain function! This is a substantial decline.

The message is clear. It's not smart to ignore diabetes. You may be able to control it with diet, weight loss, exercise, and supplements. Or you may need medications. But if you have diabetes — or any other disease — deal with it now and avoid other complications.

Is a Vegetarian Diet Safe?

You can find a study to support any point of view. This is especially true in the case of diet and nutrition. One bias is that a vegetarian diet is unhealthy, leading to fatigue, low libido, and various diseases. It can be, if the vegetarian diet doesn't contain enough protein and if it's not a balanced diet. And a vegetarian diet isn't for everyone. It works for me, but not for a lot of my patients. But vegetarian diets can be a healthy choice.

Recently, I received a book that points out how vegetarian diets lead to protein deficiency, mineral depletion, and low vitality. The authors didn't mention that many meat-eaters tend to be obese and have degenerative diseases, such as heart disease, colon cancer, and diabetes. Not all, of course. Neither does a balanced vegetarian diet necessarily lead to low vitality. All of us need to eat a diet with sufficient protein and plenty of fresh fruits and vegetables, as well as the right kind of fats.

Another bias is that soy is harmful. The book I received quoted Sally Fallon and Mary G. Enig, PhD, who are convinced that soy is one of the worst foods you can eat. I disagree. But it's not just my opinion versus theirs. When I talk to my colleagues and read sound scientific studies, I find that very few people agree with Fallon and Enig. Mark Messina, a PhD in nutrition who heads the yearly International Soy Symposium, also finds it safe.

It's fine to disagree about diet and nutrition. But let's get beyond personal biases and look at the science behind the statements. Too often, it's faulty. I'm here to sift through the current medical information and nutritional studies and separate fact from fiction for you.

Ask Dr. Nan

Q: I’m interested in getting more CLA in my diet to enhance lean muscle mass. I’d like to use organic safflower oil with my food to do this. Do you have an opinion? — R.R., via e-mail

A: Yes, I do. CLA, or conjugated linoleic acid, is found naturally in dairy products and grass-fed beef or lamb. The bacteria in the intestines of these animals convert linoleic acid (a fatty acid found in plants) into CLA. However, your body can’t do this. And the CLA content in foods has declined with the use of antibiotics, leaving us with fewer options. So we need to take CLA supplements if we want high amounts. The safflower oil has some, but not enough, especially for building muscle mass.

It’s true that CLA can help improve lean muscle mass. But studies show it takes around six to seven grams of CLA per day to get this effect. Most people don’t use enough of it for muscle enhancement.

If you decide to give this supplement a try, shop carefully. CLA supplements for building muscles can be rather expensive. Prices range from $16.99 for 60 softgels (a mere 10-day supply) to $22 for 180 softgels (a one-month supply). All are 1,000 mg (or 1 gram). And, remember, if you’re taking Vitality Plus, you’re already getting 500 mg each day. Vanderhaeghe, Lorna R. BSc, and Karlene Karst, BSc, RD. Healthy Fats for Life, Quarry Health Books, 2003.

Q: My 40-year-old son has problems swallowing. An endoscopy revealed scar tissue on the stomach side of the esophagus’ opening. His doctor gave him a trial of Nexium and said he’d give him more if it helped. I’m concerned that Nexium treats the symptoms of his acid reflux and not its cause. What causes acid reflux? — J.G., e-mail

A: Thank you for this question. It just goes to show that many articles in this newsletter apply to men as well as women — and people of all ages.

I wrote an article on acid reflux in the June 2003 issue called “Take Acid — Not Antacids — To End Your Heartburn.” You can read this article on my website (the current user name and password are on page 7). Too much acid does not necessarily cause acid reflux.

Oftentimes, a malfunctioning valve between the stomach and esophagus — called the lower esophageal sphincter (LES) — is the cause. When this valve isn’t working properly, acid can back up into the esophagus and cause an irritation.

Nexium, and other medications that neutralize stomach acid, just reduce the amount of acid that can back up. As you suspected, they treat the symptom, not the underlying cause.

After you read my article, please get Dr. Jonathan Wright’s book, Why Stomach Acid Is Good For You (M. Evans and Company, 2001). It explains in detail why too little stomach acid can cause more problems than too much. It also lists foods that irritate the esophagus, as well as foods that weaken the LES.

Your son may be able to correct the cause of his discomfort simply by avoiding certain foods and taking natural supplements that repair the stomach lining. These supplements include DGL (deglycyrrhizinated licorice) and hydrochloric acid (HCl). Just be aware that he’ll need to take the HCl under the direction of a knowledgeable doctor.