Natural Foods Merchandiser

Nutrition Q&A with Dan Lukaczer, N.D.

Q: Is there any truth to reports that coffee may be good for our health?

A: A recent study in the United States and another in Finland both came to that conclusion. Coffee consumption appears to decrease the risk of type II diabetes in both men and women in a dose-dependent manner. That is, the more you drink, the less your risk.1,2 In the U.S. study (after adjusting for diabetic risk factors), it was found that drinking six or more cups of coffee per day cut the risk of diabetes in half for men and by a third for women.

Researchers are not quite sure what it is in a cup of joe that?s good for you, but it does not appear to be only the caffeine, as decaffeinated-coffee drinkers also had some, although not as much, decreased diabetic risk. Therefore, other ingredients probably have some effect. Whatever it is, coffee appears to improve insulin sensitivity and enhanced insulin response.3 However, drinking pots of coffee is not something I would generally recommend because coffee can raise your heart rate and result in nervousness, anxiety and insomnia. There seem to be better ways to lower one?s risk of diabetes. That said, it is nice to know about some positive aspects of this traditional ?vice.?

Q: I?ve been told to stay away from foods high in purines because I have gout. But a lot of foods have purines—do I stay away from all of them?

A: Diets high in purines (a nitrogen-containing compound) and high in protein have long been suspected of increasing the risk of gout. Gout is a type of arthritis caused by high levels of uric acid in the body that form crystals in the joints, resulting in pain and inflammation. However, a recent report looking at data from the ongoing U.S. Physicians Health Study suggested that purine-rich legumes and vegetables are not associated with an increased risk of gout. While study participants who consumed the highest amount of meat and seafood (rich sources of purines) were 40 percent to 50 percent more likely to have gout than those who ate the least amount, there was no increased risk associated with a diet that included beans, cauliflower, mushrooms, peas or spinach—all of which are considered high in purines.

Another interesting finding coming out of the Physicians Health Study is gout?s association with alcohol consumption. The common understanding is that alcohol increases the risk of gout because it also increases uric acid levels. While an analysis of the data supported this long-held conclusion, it found differences in the gout risk posed by different alcoholic beverages. Beer consumption showed the strongest independent association—with a 49 percent increased risk per 12-oz serving per day—followed by hard liquor at a 15 percent increased risk. However, moderate wine consumption was not associated with an increased risk.4 So, the bottom line for people with gout: Decrease intake of meat and seafood, but vegetables and legumes that have purines are fine; and moderate wine intake is OK, but stay away from beer and liquor.

Q: I?ve heard we may not be getting enough vitamin D, even at the recommended dietary intake.

A: This may be true. A plethora of recently published research on vitamin D has shown that insufficient intake may be associated with increased risk for certain kinds of cancer, types I and II diabetes, heart disease and osteoporosis.5,6 For instance, we know that without vitamin D the small intestine absorbs no more than 10 percent to 15 percent of dietary calcium. In a person with vitamin D sufficiency, however, the small intestine absorbs an average of 30 percent dietary calcium. Numerous epidemiological studies suggest that exposure to sunlight, which enhances the production of vitamin D in the skin, is important in preventing many chronic diseases. Yet many adults, both old and young, either avoid sun exposure purposely or spend so much time inside that they don?t get enough.

So how much vitamin D is sufficient? Some experts suggest that the current recommended dietary intakes for vitamin D are actually inadequate.7 The RDI for adults 50 years old and younger is 200 IU/day, ages 51 to 70 is 400 IU/day, and greater than 70 is 600 IU/day. Without adequate sun exposure, however, a minimum of 1,000 IU vitamin D daily may be required for all ages.6,7

1. Salazar-Martinez E, Willett WC, et al. ?Coffee consumption and risk for type 2 diabetes mellitus.? Ann Intern Med 2004;140(1):1-8.
2. Tuomilehto J, Hu G, et al. ?Coffee consumption and risk of type 2 diabetes mellitus among middle-aged Finnish men and women.? JAMA 2004;291(10):1213-9.
3. Agardh EE, Carlsson S, et al. ?Coffee consumption, type 2 diabetes and impaired glucose tolerance in Swedish men and women.? J Intern Med 2004;255(6):645-52.
4. Choi HK, Atkinson K, et al. ?Alcohol intake and risk of incident gout in men: a prospective study.? Lancet 2004;363(9417):1277-81.
5. Chiu KC, Chu A, et al. ?Hypovitaminosis D is associated with insulin resistance and beta cell dysfunction.? Am J Clin Nutr 2004;79(5):820-5.
6. Holick MF. ?Vitamin D: importance in the prevention of cancers, type 1 diabetes, heart disease, and osteoporosis.? Am J Clin Nutr 2004;79(3):362-71.
7. Vieth R. ?Why the optimal requirement for vitamin D(3) is probably much higher than what is officially recommended for adults.? J Steroid Biochem Mol Biol 2004;89-90:575-9.

Natural Foods Merchandiser volume XXV/number 10/p. 116

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