Behind the headlines."Study Finds Low-Fat Diet low-fat diet A diet low in fats, especially saturated fats, which has a positive effect on arthritis, CA, ASHD, DM, HTN, obesity, and strokes. See Diet, Low-fat snack; Cf Animal fat, High-fat diet. Won't Stop Cancer or Heart Disease," ran the headline in The New York New York, state, United States New York, Middle Atlantic state of the United States. It is bordered by Vermont, Massachusetts, Connecticut, and the Atlantic Ocean (E), New Jersey and Pennsylvania (S), Lakes Erie and Ontario and the Canadian province of Times. "Big Study Finds No Clear Benefit of Calcium Pills," the Times declared a week later. In February, the government announced the latest findings from its Women's Health Initiative Women's Health Initiative A 15-yr, $628 million project involving 1. An observational study of the health habits and medical Hx of ±100,000 ♀ 2. . The two studies of roughly 50,000 women asked two questions: Could a low-fat diet prevent breast cancer, colorectal cancer colorectal cancer Malignant tumour of the large intestine (colon) or rectum. Risk factors include age (after age 50), family history of colorectal cancer, chronic inflammatory bowel diseases, benign polyps, physical inactivity, and a diet high in fat. , and heart disease? Do calcium and vitamin D vitamin D Any of a group of fat-soluble alcohols important in calcium metabolism in animals to form strong bones and teeth and prevent rickets and osteoporosis. It is formed by ultraviolet radiation (sunlight) of sterols (see steroid) present in the skin. prevent bone fractures and colerectal cancer? If you read only the headlines, you'd think that the answers were a flat out "no." Here's what you'd be missing. "I've been eating frozen yogurt yogurt: see fermented milk. yogurt Semisolid, fermented, often flavoured milk food. Yogurt is known and consumed in almost all parts of the world. for nothing," said one blogger. "Hey honey, bring home a bucket of KFC KFC Kentucky Fried Chicken (restaurant chain) KFC Kenya Flower Council KFC Kitchen Fresh Chicken (Kentucky Fried Chicken motto) KFC Kung Fu Cult (Cinema) KFC Kitchen Fixed Charge ," said another. Talk about confusion. Whether or not an editorial in The New York Times was correct when it declared that "Low-Fat Diets Flub (language) FLUB - The abstract machine for bootstrapping STAGE2. [Mentioned in Machine Oriented Higher Level Languages, W. van der Poel, N-H 1974, p. 271]. a Test," it's clear that somewhere along the line--as the complicated scientific findings from the Women's Health Initiative got translated into sound bites--the message got twisted. The result: millions of Americans concluded that there's no longer any reason to avoid fatty foods or take calcium and vitamin D. Wrong. For starters, the diet study was primarily designed to see if a low-fat diet could cut the risk of breast (and colorectal) cancer, so it didn't test longstanding diet advice to prevent heart disease (cut "bad" fats, but not "good" fats). What's more, the women didn't cut their fat intake much, so the study never really tested a diet with only 20 percent of calories from fat, as it intended to. Despite those shortcomings A shortcoming is a character flaw. Shortcomings may also be:
PI scientist - a person with advanced knowledge of one or more sciences . Lower-Fat Diets Cancer Q: What got lost in the headlines? A: The risk of breast cancer was 9 percent lower in the women assigned to a low-fat diet than in the women told to follow their usual diet. That reduction was not statistically significant, but it was borderline borderline /bor·der·line/ (-lin) of a phenomenon, straddling the dividing line between two categories. borderline (see "Breast Cancer," p. 5). Even though the trial is over, we have funding to follow the women until 2010, and maybe longer. It's not going to take much for the reduction in breast cancer to become statistically significant. It's close. Q: Did any women have a significantly lower risk of breast cancer? A: Yes. After eight years, the Years, The the seven decades of Eleanor Pargiter’s life. [Br. Lit.: Benét, 1109] See : Time women in the lower-fat group who started out eating the most fat--at least 37 percent of calories--had a 22 percent lower risk of breast cancer than similar women who ate their usual diets. And that difference was statistically significant. Q: So those women got the biggest bang for their buck? A: Yes. They had more room for improvement. They lowered their fat intake the most, and their risk of breast cancer was reduced. The women who started out close to, say, 32 percent of calories from fat didn't reduce their fat intake much, and their risk of breast cancer didn't change much. Q: Were they supposed to cut fat more? A: Yes. The lower-fat group was supposed to eat only 20 percent of their calories from fat. But despite intensive dietary counseling and highly motivated and dedicated participants, they did not achieve that goal. In fact, the women cut their fat to only 24 percent of calories after one year, which included 18 intensive diet counseling sessions. Then they went to maintenance sessions every three months for the rest of the study. After six years, the women reported getting 29 percent of their calories from fat. By the eighth year, fat calories may have increased further. Q: And we don't know Don't know (DK, DKed) "Don't know the trade." A Street expression used whenever one party lacks knowledge of a trade or receives conflicting instructions from the other party. that the women actually got down to 29 percent of calories from fat? A: Right. If some women reported eating less fat than they actually ate because they were assigned to a low-fat diet, that would make it harder to see a significant difference in cancer rates between groups. Q: And even 29 percent of calories from fat isn't low enough? A: Yes. We expected to see a greater difference in fat intake between the two groups. If the women had reached the goal of 20 percent of calories from fat, the study would have had strong statistical power to test the low-fat diet and breast cancer theory. Even though the study was underpowered, the difference in breast cancer rates was still borderline significant. Of course, you can never know what would have happened if the lower-fat group had actually reached the goal of 20 percent of calories from fat, but the power calculations suggest that the breast cancer reduction would have been significant. Q: What's the bottom line? A: Based on the Women's Health Initiative, women who start out with a high fat intake may lower their risk of breast cancer by reducing their fat intake. But we can't recommend that all women follow a lower-fat diet. There are hints that it may have some benefits, but we need to wait for more data to emerge over the next five years. Q: How easy is it to cut fat to 20 percent of calories? A: If the highly motivated women in this study could not do it even with very intensive dietary counseling, it may not be feasible for the general population to do it either. Q: Did you see any promising results on colorectal cancer? A: Yes. Even though there was no benefit for preventing cancer, the lower-fat group had 9 percent fewer colon polyps colon polyp Gastroenterology A hereditary or acquired pedunculated neoplasm arising from the colonic mucosa; small CPs are usually benign, but may become malignant; like colorectal CA, CPs may present with occult bleeding. See Polyp, Colorectal cancer. , which often become cancers, and that was statistically significant. It remains to be seen whether that will translate into a reduced risk of colorectal cancer with longer follow-up. Heart Disease Q: Why didn't the study cut bad fats and increase good fats? A: If this had been primarily a cardiovascular disease Cardiovascular disease Disease that affects the heart and blood vessels. Mentioned in: Lipoproteins Test cardiovascular disease prevention trial, we would have reduced saturated and trans fats trans fat n. 1. A trans fatty acid. 2. Trans fatty acids considered as a group. trans fat A fat containing trans fatty acids. drastically and allowed substitutions with polyunsaturated polyunsaturated /poly·un·sat·u·rat·ed/ (-un-sach´er-at-ed) denoting a chemical compound, particularly a fatty acid, having two or more double or triple bonds in its hydrocarbon chain. and monounsaturated fats monounsaturated fat A saturated fatty acid–ie, an alkyl chain fatty acid with one ethylenic–double bond between the carbons in the fatty acid chain. See Fatty acid, Saturated fatty acid; Cf Polyunsaturated fatty acid, Unsaturated fatty acid. . However, the primary goal of the study was to test whether reducing total fat calories to 20 percent would lower the risk of breast and colorectal cancer. In the mid-1980s, it was believed that both saturated and unsaturated fats unsaturated fat: see saturated fat. might be culprits in breast and colorectal cancer. So we told the women to cut fats across the board. Q: Cutting bad fats wasn't enough? A: You'd never get down to 20 percent of calories from fat. So we had to reduce all fats. We thought that if all fats were cut, the reduction in saturated and trans fats would be great enough to lower the risk of heart disease. But it wasn't. Q: Why look at cardiovascular disease at all? A: Heart disease and stroke kill eight times as many women as breast cancer, so we had to know how this diet would affect cardiovascular risk. What if the lower-fat diet increased risk? Then we wouldn't want to recommend it. People can follow just one dietary pattern. You might be able to take one pill to prevent heart disease or stroke and another to prevent breast or colon cancer colon cancer, cancer of any part of the colon (often called the large intestine). Colon cancer is the second most common cancer diagnosed in the United States. if those pills were available. But you can't follow one diet to prevent breast cancer and a different diet to prevent cardiovascular disease. Q: And the lower-fat group ate almost as much bad fat as the usual-diet group? A: Yes. As it turned out, there was only a small difference in the saturated and trans fat intakes of the two groups. That's not enough to have an impact on cardiovascular disease. We knew from the small effect the lower-fat diet had on LDL LDL - ["LDL: A Logic-Based Data-Language", S. Tsur et al, Proc VLDB 1986, Kyoto Japan, Aug 1986, pp.33-41]. ["bad"] cholesterol, HDL (Hardware Description Language) A language used to describe the functions of an electronic circuit for documentation, simulation or logic synthesis (or all three). Although many proprietary HDLs have been developed, Verilog and VHDL are the major standards. ["good"] cholesterol, triglycerides Triglycerides Fatty compounds synthesized from carbohydrates during the process of digestion and stored in the body's adipose (fat) tissues. High levels of triglycerides in the blood are associated with insulin resistance. , and other blood markers that there was going to be only a minimal impact on heart disease. But there was one promising finding for heart disease. The women who made the greatest reductions in saturated and trans fat and the greatest increases in fruits and vegetables did have a reduced risk. Q: Isn't it risky to look at subgroups rather than all the women in the study? A: Yes. Those analyses have some limitations because once you start to look at subgroups, you're more likely to pick results that are due to chance. Or the women in the subgroups may be making other changes that lower or raise their risk. Q: Were many of the women in the studies overweight? A: Yes. Roughly 75 percent were overweight or obese o·bese adj. Extremely fat; very overweight. obese characterized by obesity. obese adjective Characterized by obesity, see there; excessively fat , which parallels the trends in the U.S. population. Many critics of a lower-fat diet have suggested that reducing fat may lead to weight gain because people replace fat with carbohydrates Carbohydrates Compounds, such as cellulose, sugar, and starch, that contain only carbon, hydrogen, and oxygen, and are a major part of the diets of people and other animals. Mentioned in: Laxatives carbohydrates, n. . We did not find evidence for weight gain or for any adverse effects on cholesterol, triglycerides, and blood glucose blood glucose Diabetology The principal sugar produced by the body from food–especially carbohydrates, but also from proteins and fats; glucose is the body's major source of energy, is transported to cells via the circulation and used by cells in the presence or insulin. In fact, after one year, we found a modest five-pound weight reduction in women in the lower-fat diet group compared to women in the usual-diet group. At six years, the difference between groups narrowed to just one or two pounds. It wasn't a great difference, probably because there was little difference between calorie calorie, abbr. cal, unit of heat energy in the metric system. The measurement of heat is called calorimetry. The calorie, or gram calorie, is the quantity of heat required to raise the temperature of 1 gram of pure water 1°C;. intake in the two groups. In any case, there's no evidence for weight gain with this lower-fat, higher-carb diet. Q: Why didn't you advise the overweight women to lose weight? A: We didn't tell the women not to lose weight. They were free to hose weight if they wanted to, but we didn't counsel them to restrict calories or lose weight. It's very difficult to maintain a restricted calorie intake over the long term. So instead, we advised the women to replace fat calories with calories from fruits, vegetables, and grains. Also, let's say there had been a sustained 15-to-20-pound weight loss over eight years. That in itself might have had a benefit for breast cancer, heart disease, and diabetes, regardless of whether the diet was low in fat. So we wouldn't know whether restricting calories or replacing fat with carbohydrate carbohydrate, any member of a large class of chemical compounds that includes sugars, starches, cellulose, and related compounds. These compounds are produced naturally by green plants from carbon dioxide and water (see photosynthesis). made the difference. Q: What's the bottom line? A: These findings aren't license for women to run out and have a triple cheeseburger and fries or pizza every day. Everyone should reduce saturated and trans fat and increase fruits, vegetables, whole grains, fiber, and fish. And we know that it's important to stay physically active, quit smoking, and maintain a healthy weight. Despite the headlines, there's evidence from other studies that 80 percent of heart disease and stroke, maybe 90 percent of diabetes, and 30 to 50 percent of cancers can be prevented by a healthy diet, more exercise, and not smoking. Breast Cancer Women who were told to eat a lower-fat diet (darker line had a 9 percent lower risk of breast cancer than women who ate their usual diet (lighter line). The difference was almost statistically significant, and it could easily reach significance as the women are followed for longer. [GRAPHICS OMITTED] Source: JAMA JAMA abbr. Journal of the American Medical Association 295: 629-642, 2006. (See also pp. 653, 655, 691). Copyright[c] 2006 American Medical Association American Medical Association (AMA), professional physicians' organization (founded 1847). Its goals are to protect the interests of American physicians, advance public health, and support the growth of medical science. . The Bottom Line Low-Fat-Diet Study Headline: A low-fat diet doesn't prevent breast cancer, colorectal cancer, or heart disease. Behind the headline: * Few women cut as much fat as they were instructed to. * The study came extremely close to finding a significantly lower risk of breast cancer in the entire lower-fat group. * Women in the lower-fat group who cut their fat the most had a significant 22 percent lower risk of breast cancer. * The study didn't cut "bad" fat (saturated and trans) enough to lower the risk of heart disease. * Women on the lower-fat diet had fewer precancerous precancerous /pre·can·cer·ous/ (-kan´ser-us) pertaining to a pathologic process that tends to become malignant. pre·can·cer·ous adj. colon polyps, which suggests that their risk of colorectal cancer might fall over time Calcium & Vitamin D Q: What did you find in the calcium and vitamin D trial? A: When we looked at all the women in the study, we found a 12 percent lower risk of hip fracture hip fracture Orthopedic surgery A femoral fracture which affects 1/6 white ♀–US during life Epidemiology 250,000/yr–US Specifics Proximal femur; 90+% femoral neck, intertrochanteric; 5-10% are subtrochanteric Risk factors Tall, thin ♀, in those who were randomly assigned to take 1,000 mg of calcium--as calcium carbonate--and 400 lU of vitamin D every day rather than a placebo. But the reduction wasn't statistically significant. However, when we looked at those women who took their supplements at least 80 percent of the time, we found a 21 percent lower risk of hip fracture. So that's strong evidence that calcium and vitamin D strengthen hip bones. Also, when we looked at the women who were 60 and older when they entered the study--whether or not they took their pills at least 80 percent of the time--the risk of hip fracture was 29 percent lower in calcium takers than in placebo takers. And that difference was statistically significant. We found no evidence of benefit for wrist or spine fractures or for colorectal cancer. Q: Did calcium and vitamin D make hip bones denser? A: Yes. A sample of the women had regular bone density measurements, and we found a significantly higher hip bone density in those who were told to take calcium and vitamin D than in the placebo group (see "Hip Bone Density"). Q: Any idea why calcium and vitamin D didn't prevent more hip fractures? A: About 40 percent of the women stopped taking the pills either because they were taking calcium and vitamin D on their own outside the study or because they just didn't want to take the pills any more. When those women are included, it dilutes the impact of calcium and vitamin D. Also, the hip fracture rate was lower than we expected when the study was designed. We think that's because the study had fewer women over age 70 and more overweight women than we expected. Overweight women have a lower risk of fractures. Also, the women in the study were getting more calcium than we anticipated. And many of these women were given hormone replacement therapy Hormone Replacement Therapy Definition Hormone replacement therapy (HRT) is the use of synthetic or natural female hormones to make up for the decline or lack of natural hormones produced in a woman's body. in another part of the study. That may have also lowered the fracture rates in both groups. Q: Fewer fractures means that it's harder to see a difference between groups? A: Yes. The study was designed to have an 85 percent likelihood of detecting a significant difference in hip fractures, but because there were fewer fractures in both the treatment and the placebo groups, we ended up with only a 48 percent chance of seeing a significant difference. Q: How much calcium and D were the placebo takers getting? A: Before the study started, the women in both groups averaged almost 1,200 mg of calcium and nearly 400 lU of vitamin D a day from food and supplements. Q: So the trial may have tested 1,200 mg vs. 2,200 mg of calcium and 400 lU vs. 800 lU of vitamin D a day? A: Yes, at least for many of the women. And that may have limited the study's ability to see a bigger benefit of calcium and vitamin D supplements. It's possible that once you get to 1,200 mg or so of calcium, there is a threshold effect In particle physics, the term threshold effect usually refers to small corrections to rough calculations based on the renormalization group that arise from the detailed behavior near the scale where new physics takes place. . More may have little benefit. But it wouldn't have been ethical to tell all the women to stop eating calcium-rich foods and to stop taking their own calcium supplements, because that would have made the women who ended up in the placebo group calcium-deficient. Q: Why did calcium and vitamin D appear to double the risk of hip fractures in women aged 50 to 59? A: We don't know. It may be a fluke fluke, parasitic flatworm of the trematoda class, related to the tapeworm. Instead of the cilia, external sense organs, and epidermis of the free-living flatworms, adult flukes have sucking disks with which they cling to their hosts and an external cuticle that , even though it was statistically significant. However, among women aged 50 to 59, there were very few fractures, and most fractures in that age group were probably caused by trauma, not osteoporosis osteoporosis (ŏs'tēō'pərō`sĭs), disorder in which the normal replenishment of old bone tissue is severely disrupted, resulting in weakened bones and increased risk of fracture; osteopenia . Q: So should women in their 50s stop taking calcium and vitamin D? A: No. We have no other good evidence to suggest that calcium and vitamin D increase the risk of hip fractures in any age group. Also, calcium and vitamin D improve bone density and that may serve as a bone bank for postmenopausal post·men·o·paus·al adj. Of or occurring in the time following menopause. postmenopausal Change of life Gynecology adjective Referring to the time in ♀ when menstrual periods stop for ≥ 1 yr women. I think of it as insurance against osteoporosis later on. Women should also have a bone density scan by age 65, or earlier if they have risk factors for osteoporosis (see "Who's at Risk?"). Q: Can we conclude that calcium and vitamin D don't protect against colon cancer? A: No. We found no reduction in rates of colorectal cancer, but the treatment lasted only seven years. We know that colorectal cancer may take 10 to 20 years to develop, so it's possible that calcium and vitamin D might reduce the risk over a longer term. In the best-case scenario, you'd like colorectal cancer trials to last for 15 to 20 years. But it's extraordinarily expensive and compliance tends to wane after 5 or 10 years if not earlier, so it's not feasible. We will continue to follow this group for another five years to look for benefits. Q: Did the women who were given calcium and vitamin D have fewer polyps Polyps A tumor with a small flap that attaches itself to the wall of various vascular organs such as the nose, uterus and rectum. Polyps bleed easily, and if they are suspected to be cancerous they should be surgically removed. , as some studies have found? A: No. But in a Dartmouth Medical Center trial of 930 men and women who had a history of polyps, those who were given 1,200 mg of calcium a day had fewer new polyps than those who took a placebo. We're not sure why that trial got different results, but it was a high-risk population and three-quarters of the participants were men. Q: Were there any side effects Side effects Effects of a proposed project on other parts of the firm. of calcium and vitamin D? A: We found a small but significant 17 percent increase in kidney stones Kidney Stones Definition Kidney stones are solid accumulations of material that form in the tubal system of the kidney. Kidney stones cause problems when they block the flow of urine through or out of the kidney. . But remember that many of these women were getting roughly 2,200 mg a day of calcium. The risk of kidney stones may not be increased if women get the recommended 1,200 mg a day. Q: What's the bottom line? A: Taking calcium and vitamin D should reduce the risk of hip fractures in women aged 60 and older. So the findings support the current guidelines guidelines, n.pl a set of standards, criteria, or specifications to be used or followed in the performance of certain tasks. on calcium and vitamin D (see "Protecting Bones"). The Bottom Line Calcium Study Headline: Calcium and vitamin D don't prevent bone fractures or colorectal cancer. Behind the headline: * Roughly 40 percent of the women stopped taking their pills during the study. * Among women who took at least 80 percent of their pills, the risk of hip fractures was 29 percent lower in those who were given calcium and vitamin D. * Among women aged 60 or over, the risk of hip fractures was 21 percent lower in those who were given calcium and vitamin D. * Women who were given calcium and vitamin D had significantly higher hip bone density. * Women who were given calcium and vitamin D had a small but significant increased risk of kidney stones. Many of those women got roughly 2,200 mg of calcium and 800 IU of vitamin D a day. Who's At Risk? If you're over 65 or you're female, white, postmenopausal, and have at least one other risk factor for fractures, it's worth getting a bone density test. Some risk factors you can't control; others you can. (Being frail or in poor health could fall into either category.) In the Study of Osteoporotic Fractures, which tracked more than 9,500 men and women for four years, the four risk factors in bold had the largest impact on who broke a hip. Risk Factors You CAN'T CONTROL You're at risk if you: * fractured a bone as an adult * have a mother, father, or sibling sibling /sib·ling/ (sib´ling) any of two or more offspring of the same parents; a brother or sister. sib·ling n. with a history of fractures * are Caucasian * are over age 65 * are a woman * have dementia * are frail or in poor health Risk Factors You MAY BE ABLE TO CONTROL You're at risk if you: * smoke cigarettes * have an estrogen deficiency. That means you started menopause menopause (mĕn`əpôz) or climacteric (klīmăk`tərĭk, klī'măktĕr`ĭk) before age 45 or are premenopausal pre·me·no·paus·al adj. Of or relating to the years or the stage of life immediately before the onset of menopause. premenopausal adjective but haven't menstruated for more than a year. * weigh less than 127 pounds * have a chronic low calcium intake * suffer from alcoholism alcoholism, disease characterized by impaired control over the consumption of alcoholic beverages. Alcoholism is a serious problem worldwide; in the United States the wide availability of alcoholic beverages makes alcohol the most accessible drug, and alcoholism is * have impaired eyesight eye·sight n. 1. The faculty of sight; vision. 2. Range of vision; view. * suffer repeated falls * don't get enough physical activity * are frail or in poor health Source: National Osteoporosis Foundation The National Osteoporosis Foundation (NOF) is an American voluntary health organization dedicated to osteoporosis and bone health. Its headquarters are in Washington, D.C.. . Hip Bone Density Women who were given calcium and vitamin D (blue line) had higher hip bone density than women who were given a placebo (red line). The risk of hip fractures was 29 percent lower in women who took at least 80 percent of their calcium and vitamin D pills. However, the difference in hip fracture rates wasn't statistically significant when the researchers included women who stopped taking their pills during the study. Source: N. Engl. J. Med 354: 669-83, 2006. (See also pp. 684, 750, 752.) Copyright [c] 2006 Massachusetts Medical Society The Massachusetts Medical Society (MMS) is the oldest continuously-operating state medical society in the United States. Incorporated on November 1, 1781, by an act of the Massachusetts General Court, the MMS is a non-profit organization that consists of approximately 18,500 . All rights reserved. JoAnn E. Manson is one of the principal investigators of the Women's Health Initiative studies. She is chief of the Division of Preventive Medicine preventive medicine, branch of medicine dealing with the prevention of disease and the maintenance of good health practices. Until recently preventive medicine was largely the domain of the U.S. at Brigham and Women's Hospital Brigham and Women's Hospital (BWH) is a hospital in the Longwood Area of the Boston, Massachusetts neighborhood of Mission Hill. With Massachusetts General Hospital, it is one of the two founding members of Partners HealthCare. and professor of medicine at Harvard Medical School Harvard Medical School (HMS) is one of the graduate schools of Harvard University. It is a prestigious American medical school located in the Longwood Medical Area of the Mission Hill neighborhood of Boston, Massachusetts. in Boston. She spoke to Nutrition Action's Bonnie bon·ny also bon·nie adj. bon·ni·er, bon·ni·est Scots 1. Physically attractive or appealing; pretty. 2. Excellent. Liebman by phone from Boston.
Not Another Reversal!
To read the newspapers, you'd think that the Women's Health Initiative
overturned the latest diet advice. In fact, the study didn't test the
government's current advice on how to reduce the risk of heart disease,
cancer, diabetes, or obesity.
Current Advice
Total Fat 20%-35% of calories
(45-80 grams, if you eat 2,000 calories a day)
Saturated Fat less than 10% of calories
(20 grams, if you eat 2,000 calories a day)
Trans Fat as little as possible
Cholesterol less than 300 milligrams a day
Fruits & 9 servings or more a day
Vegetables (2 cups fruit + 2 1/2 cups vegetables)
Grains 6 or more servings a day, at least half of them
whole grains
Sodium less than 2,300 milligrams a day
(1,500 mg if you're middle-aged or older, have
high blood pressure, or are African American)
Weight maintain a healthy weight
Physical at least 30 minutes a day
Activity (60-90 minutes to prevent weight gain as you age)
Source: Dietary Guidelines for Americans
(healthierus.gov/dietaryguidelines). Advice from the American Heart
Association (americanheart.org) and American Cancer Society
(cancer.org) is similar.
Protecting Bones
Food or Shoot for This Much What You Need to Know
Nutrient Every Day
Calcium 1,000 mg if 19 to 50 To protect the prostate, men
1,200 mg if over 50 shouldn't exceed 1,500 mg.
Vitamin D 400 IU if 50 to 70 Shoot for 1,000 IU if you're
600 to 1,000 IU if over 70 over 70 and get no sun
exposure.
Vitamin K 150 to 250 mcg Talk to your doctor if you
take blood-thinning drugs.
Protein At least 46 grams (women) If one study is correct,
At least 56 grams (men) older people may need 90
grams a day.
Potassium 4,700 mg Get it from foods, not
supplements.
Fruits & 4 1/2 cups There's no better way to get
Vegetables potassium and vitamin K.
Exercise 30 minutes or more To get or stay trim, you'll
need 60 to 90 minutes a day.
Source: CSPI
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